Metabolic Score for Insulin Resistance and New-Onset Type 2 Diabetes in a Middle-Aged and Older Adult Population: Nationwide Prospective Cohort Study and Implications for Primary Care

• DOI: 10.2196/49617
• Publication Date: 2024-06-03T18:00:45Z
• Authors: Hui Cheng; Zhihui Jia; Yu Ting Li; Xiao Yu; Jia Ji Wang; Yao Jie Xie; Jose Hernandez; Harry H X Wang
• Keywords: Male; Blood Glucose; Original Paper; China; Primary Health Care; Incidence; Middle Aged; 0302 clinical medicine; Diabetes Mellitus, Type 2; Risk Factors; Humans; Female; Prospective Studies; Public aspects of medicine; RA1-1270; Insulin Resistance; Aged

Background The metabolic score for insulin resistance (METS-IR) has emerged as a noninsulin-based index the approximation of (IR), yet longitudinal evidence supporting utility METS-IR in primary prevention type 2 diabetes mellitus (T2DM) remains limited. Objective We aimed to investigate association between METS-IR, which combines fasting plasma glucose (FPG), lipid profiles, and anthropometrics that can be routinely obtained resource-limited care settings, incidence new-onset T2DM. Methods conducted closed-cohort analysis nationwide, prospective cohort 7583 Chinese middle-aged older adults who were free T2DM at baseline, sampled from 28 out 31 provinces China. examined characteristics participants stratified by elevated blood pressure (BP) baseline follow-up. performed Cox proportional hazard regression explore associations with incident overall BP. also applied net reclassification improvement integrated discrimination examine incremental value METS-IR. Results During mean follow-up period 6.3 years, occurred 527 participants, among two-thirds (332/527, 62.9%; 95% CI 58.7%-67.1%) had FPG<110 mg/dL. A SD unit increase was associated first (adjusted ratio [aHR] 1.33, 1.22-1.45; P<.001) all participants. similar results normal BP (aHR 1.41, 1.22-1.62; 1.29, 1.16-1.44; P<.001). predictive capability improved adding FPG. In study whose FPG <126 mg/dL <110 mg/dL, 62.9% (332/527; 60%-65.9%) 58.1% (193/332; 54.3%-61.9%) above cutoff values, respectively. Conclusions significantly T2DM, regardless level. Regular monitoring on top routine clinical practice may add ability enhance early identification populations risk