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胰岛素抵抗代谢评分及其6年变化与2型糖尿病发病的关联。

Association of metabolic score for insulin resistance and its 6-year change with incident type 2 diabetes mellitus.

作者信息

Zhang Ming, Liu Dechen, Qin Pei, Liu Yu, Sun Xizhuo, Li Honghui, Wu Xiaoyan, Zhang Yanyan, Han Minghui, Qie Ranran, Huang Shengbing, Li Yang, Wu Yuying, Yang Xingjin, Feng Yifei, Zhao Yang, Hu Dongsheng, Hu Fulan

机构信息

Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University, Shenzhen, China.

Study Team of Shenzhen's Sanming Project, The Affiliated Luohu Hospital of Shenzhen University Health Science Center, Shenzhen, China.

出版信息

J Diabetes. 2021 Sep;13(9):725-734. doi: 10.1111/1753-0407.13161. Epub 2021 Feb 28.

Abstract

BACKGROUND

The evidence for the association between metabolic score for insulin resistance (METS-IR) and type 2 diabetes mellitus (T2DM) is limited. We aimed to explore the association of METS-IR and its 6-year change with risk of incident T2DM in a rural Chinese population.

METHODS

We analyzed data for 12 107 participants (mean age 50.48 years). A Cox proportional-hazard model was used to estimate the association of METS-IR with incident T2DM by using hazard ratios (HRs) and 95% confidence intervals (CIs); a logistic regression model was used to assess the association of 6-year METS-IR change with incident T2DM by using odds ratios (ORs) and 95% CIs. We used subgroup analyses of the association of METS-IR and its 6-year change with incident T2DM by sex, age, and baseline fasting plasma glucose (FPG) level as well as restricted cubic splines to describe the dose-response association.

RESULTS

The association of METS-IR and 6-year METS-IR change with incident T2DM was significant (per SD unit increase: HR = 1.80, 95% CI: 1.60-2.02 for METS-IR, OR = 1.42, 95% CI: 1.28-1.57 and OR = 1.59, 95% CI: 1.44-1.76 for relative and absolute METS-IR change). The significant association remained on subgroup analyses by sex, age, and baseline FPG level. Dose-response analysis demonstrated that the probability of incident T2DM was significantly increased with increasing METS-IR and 6-year METS-IR change.

CONCLUSIONS

Increased METS-IR and 6-year METS-IR change were positively associated with risk of incident T2DM in a rural Chinese population. METS-IR may be a vital indicator for identifying T2DM.

摘要

背景

胰岛素抵抗代谢评分(METS-IR)与2型糖尿病(T2DM)之间关联的证据有限。我们旨在探讨中国农村人群中METS-IR及其6年变化与新发T2DM风险的关联。

方法

我们分析了12107名参与者(平均年龄50.48岁)的数据。采用Cox比例风险模型,通过风险比(HR)和95%置信区间(CI)估计METS-IR与新发T2DM的关联;采用逻辑回归模型,通过比值比(OR)和95%CI评估6年METS-IR变化与新发T2DM的关联。我们按性别、年龄和基线空腹血糖(FPG)水平对METS-IR及其6年变化与新发T2DM的关联进行亚组分析,并使用受限立方样条来描述剂量反应关联。

结果

METS-IR及其6年变化与新发T2DM的关联具有显著性(每增加1个标准差单位:METS-IR的HR = 1.80,95%CI:1.60 - 2.02;相对和绝对METS-IR变化的OR分别为1.42,95%CI:1.28 - 1.57和OR = 1.59,95%CI:1.44 - 1.76)。在按性别、年龄和基线FPG水平进行的亚组分析中,这种显著关联依然存在。剂量反应分析表明,随着METS-IR及其6年变化增加,新发T2DM的概率显著增加。

结论

在中国农村人群中,METS-IR升高及其6年变化与新发T2DM风险呈正相关。METS-IR可能是识别T2DM的重要指标。

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