New Study: METS-IR May Help Identify Heart Disease Risk
This study explores the association between METS-IR, a novel insulin resistance marker, and arterial stiffness. It suggests METS-IR as a simple, potentially valuable tool in primary care for identifying individuals at high risk of cardiovascular disease.
DR T S DIDWAL MD
3/5/20245 min read
This study in Frontiers in Endocrinology. examined a new score called METS-IR, which reflects insulin resistance, and its connection to heart disease risk. They looked at people who received health checkups in Japan. The results showed a strong link between higher METS-IR scores and stiffer arteries, a risk factor for heart disease. This suggests METS-IR, due to its ease of calculation, could be a useful tool in primary care to identify people at high risk of heart disease, allowing for early intervention. This study investigated the connection between a novel measure of insulin resistance (METS-IR) and arterial stiffness (baPWV) in participants of a health check-up program in Japan.
Key findings:
Positive association: The study found a significant positive association between METS-IR and baPWV, indicating that higher METS-IR scores are linked with increased arterial stiffness.
Subgroup analysis: This association remained even after considering factors like age, sex, and lifestyle habits. However, it was stronger in participants with:
Normal kidney function
No or minimal alcohol consumption
Non-smoking status
No regular exercise
No fatty liver disease
Normal blood pressure
Potential application: The study suggests METS-IR, due to its ease of calculation, could be a valuable tool in primary care to identify individuals at high risk for cardiovascular disease, allowing for early intervention.
Limitations:
Cross-sectional design: This study only establishes an association, not necessarily a causal relationship, between METS-IR and baPWV.
Limited generalizability: The study population was from a specific region in Japan, potentially limiting generalizability to other populations.
Need for further research: The authors call for future large-scale, prospective studies to confirm these findings.
Overall, this study provides evidence for a positive association between METS-IR and baPWV, suggesting the potential use of METS-IR in identifying individuals at risk for cardiovascular disease in primary care settings. However, further research is needed to confirm these findings and explore causal relationships.
METS-IR stands for Metabolic Score for Insulin Resistance. It's a metabolic index that measures peripheral insulin sensitivity in humans. It can also be used to evaluate cardiometabolic risk in both healthy and at-risk subjects. Insulin resistance (IR), a condition where cells fail to respond adequately to insulin, has long been implicated in the pathogenesis of cardiovascular diseases (CVD). Arterial stiffness, a hallmark of vascular aging, is increasingly recognized as a crucial predictor of CVD risk. Numerous studies have delved into the intricate relationship between IR and arterial stiffness, shedding light on potential mechanisms and clinical implications. In this comprehensive analysis, we delve into recent findings, focusing particularly on the correlation between IR, as assessed by various surrogate markers, and arterial stiffness, as measured by brachial-ankle pulse wave velocity (baPWV), in a Japanese medical examination population.
Methods
The study involved participants from Murakami Memorial Hospital's health checkup program in Gifu, Japan. This program aims to identify and manage chronic diseases. Participants included individuals who underwent baPWV measurements between March 2004 and December 2012. The study followed ethical guidelines and obtained informed consent from participants. It adhered to recommended reporting standards. Certain individuals were excluded from the study, such as pregnant women, those taking specific medications, and those with an abnormal ankle-brachial index. This ensured the accuracy of baPWV readings and participant eligibility.
Understanding the Relationship:
Recent cross-sectional studies have underscored a significant and linear correlation between IR and arterial stiffness, as evidenced by baPWV measurements, in Japanese health check-up individuals. Factors such as age, sex, BMI, and lifestyle habits were meticulously controlled for, with results demonstrating robust associations between IR and arterial stiffness across various subgroups.
Exploring Surrogate Markers:
While the traditional measure of IR relies on insulin levels, emerging evidence suggests that alternative indices, such as triglyceride/high-density lipoprotein cholesterol ratio (TG/HDL-C), triglyceride-glucose index (TyG), and metabolic score for insulin resistance (METS-IR), offer valuable insights into vascular health. Studies have revealed compelling associations between these surrogate markers and arterial stiffness, underscoring their potential clinical utility in risk stratification and early intervention.
Comparative Analysis:
Comparative analyses between surrogate markers have yielded intriguing findings. For instance, while TG/HDL-C demonstrated a non-linear correlation with baPWV, TyG emerged as a robust predictor of arterial stiffness, outperforming traditional measures like HOMA-IR. METS-IR, a novel and easily calculable index, showed promising associations with baPWV, highlighting its potential as a screening tool for CVD risk assessment.
Clinical Implications
The clinical relevance of these findings cannot be overstated. Early detection of IR-associated arterial stiffness could facilitate timely interventions aimed at mitigating CVD risk. METS-IR, in particular, emerges as a simple yet effective predictor, offering primary care physicians a valuable tool for risk stratification and personalized management strategies.
Limitations and Future Directions:
Despite the compelling evidence, certain limitations warrant acknowledgment. The cross-sectional nature of many studies precludes causal inference, highlighting the need for prospective longitudinal investigations. Additionally, the generalizability of findings to other ethnicities remains uncertain, necessitating further research in diverse populations. Addressing these gaps through rigorous prospective studies will enhance our understanding of the complex interplay between IR and arterial stiffness.
To Summarize
This study investigated the relationship between a novel insulin resistance indicator (METS-IR) and arterial stiffness (baPWV) in participants of a health check-up program in Japan.
Positive association: The study found a significant positive association between METS-IR and baPWV, indicating that higher METS-IR scores are linked with increased arterial stiffness. This association remained even after accounting for factors like age, sex, and lifestyle habits.
Novel IR marker: The study supports the use of METS-IR, a simple and easy-to-calculate score, as a potential tool in primary care to identify individuals at high risk of cardiovascular disease (CVD).
Limitations: The study acknowledges limitations, including its cross-sectional design (not establishing causality), use of secondary data (limited control for variables), and potential for unmeasured confounders. Additionally, the generalizability to other populations needs further investigation.
Comparison with other studies:
The study aligns with previous research demonstrating a connection between insulin resistance and arterial stiffness.
It adds to existing evidence by using METS-IR, a non-insulin-based marker, and focusing on a Japanese health check-up population.
Conclusion:
In conclusion, the relationship between IR and arterial stiffness represents a critical nexus in cardiovascular pathophysiology. Recent studies, particularly in Japanese health check-up populations, elucidate the significance of surrogate markers like METS-IR in predicting arterial stiffness and, by extension, CVD risk. By harnessing these insights, clinicians can adopt a proactive approach to identify high-risk individuals and institute preventive measures early in the disease trajectory. Moving forward, continued research efforts are warranted to validate these findings across diverse populations and refine risk prediction models for enhanced clinical utility.
Journal Reference
Liu, G. (2024, January 2). Association between the metabolic score for insulin resistance (METS-IR) and arterial stiffness among health check-up population in Japan: a retrospective cross-sectional study. Frontiers in Endocrinology. https://doi.org/10.3389/fendo.2023.1308719
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