Linear positive association of metabolic score for insulin resistance with stroke risk among American adults: a cross-sectional analysis of National Health and Nutrition Examination Survey datasets

J Stroke Cerebrovasc Dis. 2024 Nov;33(11):107994. doi: 10.1016/j.jstrokecerebrovasdis.2024.107994. Epub 2024 Sep 4.

Abstract

Background: Insulin Resistance (IR) is associated with stroke. This study aimed to investigate the correlation between metabolic score for insulin resistance (METS-IR) level, a new biomarker for assessing IR, and stroke.

Methods: This is a cross-sectional study based on data from the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2020 and included participants aged ≥ 20 years. All participants provided complete stroke and METS-IR related data. The study employed statistical techniques, including multivariate logistic regression analysis, restricted cubic splines (RCS), and stratified analyses to evaluate the relationship between the amounts of METS-IR and the risk of stroke.

Results: The study included 14,029 participants aged 20 years or older. The fully adjusted model revealed a statistically significant correlation between METS-IR and stroke (OR=1.21, 95% CI: 1.00, 1.46; P<0.05). Specifically, for every 10-unit increase in METS-IR, there was a 21% increase in the prevalence of stroke. The prevalence of stroke was 60% higher in the Q4 group compared to the Q1 group, as indicated by a significant association with METS-IR (OR=1.60, 95% CI: 1.01, 2.54; P<0.05). The RCS analysis revealed a strong linear correlation between METS-IR and the incidence of stroke (P<0.05). Subgroup analyses showed that gender, age, race, alcohol consumption, smoking, diabetes, and hypertension exhibited correlation with this positive association, and a significant interaction was observed in age (P for interaction < 0.05).

Conclusions: The findings of this study indicate that elevated METS-IR levels are strongly linked to a greater risk of stroke in adults.

Keywords: Cross-sectional study; Metabolic score for insulin resistance; NHANES; Stroke.

MeSH terms

  • Adult
  • Aged
  • Biomarkers / blood
  • Cross-Sectional Studies
  • Databases, Factual
  • Female
  • Humans
  • Insulin Resistance*
  • Male
  • Metabolic Syndrome* / diagnosis
  • Metabolic Syndrome* / epidemiology
  • Middle Aged
  • Nutrition Surveys*
  • Prevalence
  • Prognosis
  • Risk Assessment
  • Risk Factors
  • Stroke* / diagnosis
  • Stroke* / epidemiology
  • United States / epidemiology
  • Young Adult

Substances

  • Biomarkers