Associations of non-insulin-based insulin resistance indices with presence and extent of multi-territorial atherosclerosis: A cross-sectional study

Yanli Zhang; Mengxing Wang; Xueli Cai; Aoming Jin; Jing Jing; Suying Wang; Xia Meng; Shan Li; Qi Zhou; Xuan Wang; Tiemin Wei; Yongjun Wang; Yuesong Pan

doi:10.1016/j.jacl.2024.09.011

Associations of non-insulin-based insulin resistance indices with presence and extent of multi-territorial atherosclerosis: A cross-sectional study

J Clin Lipidol. 2024 Oct 3:S1933-2874(24)00254-X. doi: 10.1016/j.jacl.2024.09.011. Online ahead of print.

Authors

Yanli Zhang¹, Mengxing Wang², Xueli Cai³, Aoming Jin⁴, Jing Jing⁵, Suying Wang⁶, Xia Meng⁷, Shan Li⁸, Qi Zhou⁹, Xuan Wang¹⁰, Tiemin Wei¹¹, Yongjun Wang¹², Yuesong Pan¹³

Affiliations

¹ Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing, China,. Electronic address: Zhangyanli0512@163.com.
² Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing, China,. Electronic address: wmxing1227@163.com.
³ Department of Neurology, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui, China,; Cerebrovascular Research Lab, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui, China,. Electronic address: caixueli111@163.com.
⁴ Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing, China,. Electronic address: jinaoming@126.com.
⁵ Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing, China,. Electronic address: jingj_bjttyy@163.com.
⁶ Department of Neurology, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui, China,; Cerebrovascular Research Lab, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui, China,. Electronic address: lswsy1067@126.com.
⁷ Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing, China,. Electronic address: mengxia45@163.com.
⁸ Cerebrovascular Research Lab, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui, China,. Electronic address: lynn_star1976@163.com.
⁹ Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing, China,. Electronic address: q.zhou@mail.ccmu.edu.cn.
¹⁰ Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing, China,. Electronic address: wxcwxc0130@163.com.
¹¹ Department of Cardiology, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui, China,. Electronic address: lswtm@sina.com.
¹² Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing, China,; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China,; Research Unit of Artificial Intelligence in Cerebrovascular Disease, Chinese Academy of Medical Sciences, Beijing, China; Center for Excellence in Brain Science and Intelligence Technology, Chinese Academy of Sciences, Shanghai, China,. Electronic address: yongjunwang@ncrcnd.org.cn.
¹³ Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing, China,. Electronic address: yuesongpan@aliyun.com.

PMID: 39537507
DOI: 10.1016/j.jacl.2024.09.011

Abstract

Background: Non-insulin-based insulin resistance (IR) indices, simple and reliable surrogates for IR calculated without insulin level, have been reported to be associated with cardiovascular and cerebrovascular diseases.

Methods: Participants without diabetes from the cross-sectional baseline survey of the PRECISE (Poly-Vascular Evaluation for Cognitive Impairment and Vascular Events) cohort study were included in present study. Non-insulin-based IR indices, including triglyceride and glucose (TyG) index, triglyceride glucose-body mass (TyG-BMI) index, triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio, and metabolic score for insulin resistance (METS-IR) index, were calculated and stratified into quartiles. Intracranial, extracranial, coronary, subclavian, aorta, renal, ilio-femoral, and peripheral arteries were also assessed at baseline.

Results: Of 2759 included participants, the average age was 60.9 ( ± 6.6) years, and 1460 (52.9 %) were female. Compared with the first quartile of TyG index, the fourth quartile of TyG index was associated with an increased presence and extent of atherosclerotic plaques (OR, 3.51; 95 %CI,1.30-1.87; cOR, 2.22; 95 %CI,1.76-2.79) and presence and extent of atherosclerotic stenosis (OR, 1.60; 95 %CI,1.24-2.06; cOR, 1.66; 95 %CI,1.30-2.12). Such associations were also observed for the relationship of TyG-BMI index, TG/HDL-C ratio, and METS-IR index with the presence and extent of atherosclerotic plaques and stenosis. Addition of 4 non-insulin-based IR indices to the basic model with traditional risk factors improved the predictive performance of the presence of atherosclerotic plaque and stenosis.

Conclusions: Elevated non-insulin-based IR indices levels were associated with an increased risk of presence and extent of atherosclerotic plaques and stenosis in non-diabetic, older individuals in the PRECISE study. Further, these IR surrogate markers have certain predictive performance to assess the risk of multi-territorial atherosclerosis.

Keywords: Atherosclerosis; Insulin resistance; METS-IR index; TG/HDL-C ratio; TyG index; TyG-BMI index.