Su Xiaozhou, Zhao Chunli, Zhang Xianwei
Department of Cardiology, Minzu Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China.
Front Endocrinol (Lausanne). 2024 Jul 1;15:1416462. doi: 10.3389/fendo.2024.1416462. eCollection 2024.
Prior research has indicated the importance of insulin resistance in the development of heart failure (HF). The metabolic score for insulin resistance (METS-IR), a novel measure for assessing insulin resistance, has been found to be associated with cardiovascular disease (CVD). Nevertheless, the relationship between METS-IR and heart failure remains uncertain.
This cross-sectional study collected data from the 2007-2018 National Health and Nutrition Examination Survey (NHANES). Multivariable logistic regression analysis and smoothing curve fitting were performed to explore the relationship between METS-IR and the risk of heart failure. Subgroup analysis and receiver operating characteristic (ROC) curve analysis were also conducted.
A total of 14772 patients were included, of whom 485 (3.28%) had heart failure. We observed a significant positive association between METS-IR and the risk of heart failure in a fully adjusted model (per 1-unit increment in METS-IR: OR: 2.44; 95% CI: 1.38, 4.32). Subgroup analysis and interaction tests revealed no significant influence on this relationship. A saturation effect and nonlinear relationship between METS-IR and heart failure risk were found using a smoothing curve fitting analysis. The relationship was represented by a J-shaped curve with an inflection point at 40.966.
The results of our study indicated a J-shaped association between METS-IR and HF in adults in the United States. METS-IR may be a promising novel index for predicting the risk of heart failure. More longitudinal studies are needed to further verify causal relationships and validate the results in different classifications of heart failure populations.
先前的研究表明胰岛素抵抗在心力衰竭（HF）发展中的重要性。胰岛素抵抗代谢评分（METS-IR）是一种评估胰岛素抵抗的新指标，已被发现与心血管疾病（CVD）相关。然而，METS-IR与心力衰竭之间的关系仍不确定。
这项横断面研究收集了2007 - 2018年美国国家健康与营养检查调查（NHANES）的数据。进行多变量逻辑回归分析和平滑曲线拟合以探讨METS-IR与心力衰竭风险之间的关系。还进行了亚组分析和受试者工作特征（ROC）曲线分析。
共纳入14772例患者，其中485例（3.28%）患有心力衰竭。在完全调整模型中，我们观察到METS-IR与心力衰竭风险之间存在显著正相关（METS-IR每增加1个单位：OR：2.44；95%CI：1.38，4.32）。亚组分析和交互检验显示对这种关系没有显著影响。使用平滑曲线拟合分析发现METS-IR与心力衰竭风险之间存在饱和效应和非线性关系。这种关系由一条拐点为40.966的J形曲线表示。
我们的研究结果表明，在美国成年人中，METS-IR与HF之间存在J形关联。METS-IR可能是预测心力衰竭风险的一个有前景的新指标。需要更多的纵向研究来进一步验证因果关系，并在不同分类的心力衰竭人群中验证结果。
