METS-IR, a novel simple insulin resistance indexes, is associated with hypertension in normal-weight Chinese adults

Abstract

Insulin resistance (IR) plays a crucial role in the development of hypertension, so early recognition of IR is of substantial clinical importance for the management of hypertension. But traditional IR indexes are invasive, complex, and impractical. We aimed to evaluate the associations between three simple IR indexes and hypertension in different body mass index (BMI) categories. A total of 142 005 adults who did not take antihypertensive medication were included in this analysis. The ratio of triglycerides to high-density lipoprotein cholesterol (TG/HDLc), the product of fasting triglycerides and glucose (TyG), and metabolic score for IR (METS-IR) were calculated according to the corresponding formulas. The associations between them and hypertension were analyzed by logistic regression. Among the three indicators, only METS-IR had positive correlations with blood pressure levels (all P < 0.001). After full adjustment, METS-IR was significantly associated with hypertension in the normal BMI group but not in the elevated BMI group. The OR for hypertension in the normal BMI group in the highest quartile of METS-IR was 2.884 (95% CI: 2.468-3.369) in the total sample, 1.915 (95% CI: 1.614-2.271) in females and 2.083 (95% CI: 1.717-2.527) in males. Our findings indicate that METS-IR, a simple and cost-effective IR index, was strongly associated with hypertension in normal-weight Chinese subjects. It could help monitor and manage hypertension in normal-weight individuals.

Keywords: METS-IR; TG/HDLc; TyG index; hypertension; insulin resistance.

Figure 1

The proportion of hypertension by quartiles of the three non‐insulin‐based IR indexes. HDLc, high‐density lipoprotein cholesterol; METS‐IR, metabolic score for insulin resistance; Q, quartile; TG, triglycerides; TyG, TG and glucose index; Normal BMI, BMI = 18.5‐23.9 kg/m²; Elevated BMI, BMI ≥ 28.0 kg/m²

Figure 2

The ORs for hypertension in the highest quartiles of the three non‐insulin‐based IR indexes. HDLc, high‐density lipoprotein cholesterol; METS‐IR, metabolic score for insulin resistance; TG, triglycerides; TyG, TG and glucose index. Normal BMI, BMI = 18.5‐23.9 kg/m²; Elevated BMI, BMI ≥ 28.0 kg/m²