Differential Association Between Ten Indices of Insulin Resistance and End-Organ Damage in a Community of African Ancestry in Africa.

Various insulin resistance (IR) indices have been developed to assess cardiovascular (CVS) risk. We compared the association between ten IR indices and cardiac, renal, and vascular end-organ measures in a predominantly young (age 45.0 ± 18.3 years) South African Black population. We assessed the relationships between ten IR indices (homeostatic model assessment for IR [HOMA-IR], quantitative insulin sensitivity check index [QUICKI], metabolic score for IR [METS-IR], triglyceride-glucose index [TyG], TyG-body mass index [TyG-BMI], TyG-waist circumference [TyG-WC], TyG-waist-to-height ratio [TyG-WHtR], triglyceride to high-density cholesterol concentration [TyG-HDL], lipid accumulation product [LAP], visceral adiposity index [VAI]) and end-organ measures in 779 community participants of African ancestry. HOMA-IR and QUICKI were the only IR indices consistently associated with end-organ measures (left ventricular [LV] mass index, ≤ 0.005; LV relative wall thickness, < 0.0001; early-to-late mitral velocity, ≤ 0.01; E/e', ≤ 0.002; e', < 0.0001; pulse wave velocity, = 0.036 (HOMA-IR only); glomerular filtration rate [GFR], < 0.0001), independent of confounders. Furthermore, HOMA-IR was consistently higher, and QUICKI lower, in those with compared to those without end-organ damage (LV hypertrophy [ ≤ 0.03], concentric LV [ < 0.03], and reduced GFR [ ≤ 0.008]), independent of confounders. Importantly, the associations between HOMA-IR or QUICKI and end-organ measures were independent of additional CVS risk factors, including adiposity measures, and were replicated in the participants without diabetes mellitus (n = 669) and in the participants without high blood pressure (n = 505). In a predominantly young community of African ancestry, of ten recommended IR indices, only HOMA-IR and QUICKI were consistently associated with end-organ damage independent of CVS risk factors.