Associations of noninsulin-based insulin resistance indices with presence and extent of multiterritorial atherosclerosis: A cross-sectional study

Abstract

BACKGROUND

Noninsulin-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 the present study. Noninsulin-based IR indices, including triglyceride-glucose (TyG) index, triglyceride glucose-body mass index (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; common odds ratio [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 noninsulin-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 noninsulin-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 multiterritorial atherosclerosis.