Woodiwiss Angela J, Norton Gavin R, Libhaber Carlos D, Sareli Pinhas, Dessein Patrick H C
Cardiovascular Pathophysiology and Genomics Research Unit, Department of Physiology, School of Biomedical Sciences, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2193, South Africa.
J Clin Med. 2025 Apr 15;14(8):2703. doi: 10.3390/jcm14082703.
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.
人们已经开发出各种胰岛素抵抗（IR）指标来评估心血管（CVS）风险。我们在一个以年轻人为主（年龄45.0±18.3岁）的南非黑人人群中，比较了十种IR指标与心脏、肾脏和血管终末器官指标之间的关联。我们评估了十种IR指标（胰岛素抵抗的稳态模型评估[HOMA-IR]、定量胰岛素敏感性检查指数[QUICKI]、胰岛素抵抗代谢评分[METS-IR]、甘油三酯-葡萄糖指数[TyG]、TyG-体重指数[TyG-BMI]、TyG-腰围[TyG-WC]、TyG腰高比[TyG-WHtR]、甘油三酯与高密度胆固醇浓度[TyG-HDL]、脂质蓄积产物[LAP]、内脏脂肪指数[VAI]）与779名非洲裔社区参与者终末器官指标之间的关系。HOMA-IR和QUICKI是仅有的与终末器官指标始终相关的IR指标（左心室[LV]质量指数，≤0.005；LV相对壁厚度，<0.0001；二尖瓣舒张早期与晚期流速，≤0.01；E/e'，≤0.002；e'，<0.0001；脉搏波速度，=0.036（仅HOMA-IR）；肾小球滤过率[GFR]，<0.0001），不受混杂因素影响。此外，与没有终末器官损害的人相比，有终末器官损害的人（LV肥厚[≤0.03]、向心性LV[<0.03]和GFR降低[≤0.008]）的HOMA-IR始终更高，而QUICKI更低，不受混杂因素影响。重要的是，HOMA-IR或QUICKI与终末器官指标之间的关联独立于其他CVS风险因素，包括肥胖指标，并且在无糖尿病参与者（n = 669）和无高血压参与者（n = 505）中得到了重复验证。在一个以年轻人为主的非洲裔社区中，在十种推荐的IR指标中，只有HOMA-IR和QUICKI与终末器官损害始终相关，且独立于CVS风险因素。
