An Elevated METS-IR Index Is Associated With Higher Asthma Morbidity and Earlier Age of First Asthma in US Adults: Results Based on a Cross-Sectional Study

Association between a metabolic score for insulin resistance and hypertension: results from National Health and Nutrition Examination Survey 2007-2016 analyses

Background

The Metabolic Score for Insulin Resistance (METS-IR) offers a promising and reliable non-insulin-based approach to assess insulin resistance and evaluate cardiometabolic risk. However, evidence for the association between METS-IR and hypertension was still limited.

Methods

Participants from the National Health and Nutrition Examination Survey (NHANES) database from 2007-2016 were selected for weighted multivariable regression analyses, subgroup analyses and restricted cubic spline (RCS) modeling to assess the association between the METS-IR and hypertension, as well as systolic blood pressure (SBP) and diastolic blood pressure (DBP).

Results

This study enrolled 7,721 adults aged ≥20 years, 2,926 (34.03%) of whom was diagnosed as hypertension. After adjusting for all potential covariates, an increased METS-IR (log2 conversion, denoted as log2METS-IR) was independently associated with a higher prevalence of hypertension (odd ratio [OR] 3.99, 95% confidence interval [CI] 3.19~5.01). The OR for hypertension in subjects with the highest quartile of METS-IR was 3.89-fold (OR 3.89, 95% CI 3.06~4.94) higher than that in those with the lowest quartile of METS-IR. This positive correlation became more significant as METS-IR increased (p for trend < 0.001). Log2METS-IR was significantly correlated with increase in SBP (β 6.75, 95% CI 5.65~7.85) and DBP (β 5.59, 95% CI 4.75~6.43) in a fully adjusted model. Consistent results were obtained in subgroup analyses. Hypertension, SBP and DBP all exhibited a non-linear increase with the rise in METS-IR. The minimal threshold for the beneficial association of METS-IR with hypertension, SBP and DBP were all identified to be 46.88.

Conclusion

The findings of this study revealed a significant positive association between METS-IR and hypertension among US adults, suggesting METS-IR as a potential tool for assessing hypertension risk.

Relationship between weight-adjusted waist circumference index and prevalence of gallstones in U.S. adults: a study based on the NHANES 2017-2020

Objective

We aimed to assess the association between weight-adjusted waist circumference index (WWI) and gallstone prevalence in US adults.

Methods

We selected individuals from the National Health and Nutrition Examination Survey (NHANES) database from 2017 to 2020 and used logistic regression analyses, subgroup analyses, and dose-response curves to assess the association between WWI and gallbladder stone prevalence and age, sex, and ethnicity.

Results

A total of 7971 participants aged ≥20 years were enrolled in our study; 828 patients had a self-reported history of gallstones. After correcting for confounders, for each unit of WWI after Ln conversion, the prevalence of gallbladder stones increased by 34% (OR=1.34, 95% CI:1.20, 1.50). Dose-response curves showed a positive correlation between WWI and gallbladder stone prevalence.According to the subgroup analysis, the positive association between TyG index and high-frequency HI was more significant in males(OR=1.34, 95% CI:1.07, 1.69), <40 years old(OR=1.42, 95% CI:1.18, 1.71), white people Americans(OR=1.35, 95% CI:1.08, 1.68) and other races(OR= 1.56, 95% CI:1.13, 2.14).

Conclusion

Higher WWI was positively associated with the prevalence of gallbladder stones and was associated with gender, age, and ethnicity. This is noteworthy, although a causal relationship could not be established.

The METS-IR is independently related to bone mineral density, FRAX score, and bone fracture among U.S. non-diabetic adults: a cross-sectional study based on NHANES

AIM

The purpose of this study was to investigate the association between the metabolic score for insulin resistance (METS-IR) and bone mineral density (BMD) in American non-diabetic adults.

METHODS

We conducted a cross-sectional study with 1114 non-diabetic adults from the National Health and Nutrition Examination Survey cycle (2013-2014). The associations between METS-IR and BMD of total femur and spine were assessed by the multiple linear regression and verified the non-linear relationship with a smooth curve fit and threshold effect model. Furthermore, we evaluated the relationship between METS-IR, FRAX score, and history of bone fractures.

RESULTS

We found that BMD of the total femur and spine increased by 0.005 g/cm3 and 0.005 g/cm3, respectively, for a one-unit increase of METS-IR in all participants. This positive association was more pronounced among higher METS-IR participants, and there was a non-linear relationship, which was more significant when the MTTS-IRfemur was < 41.62 or the METS-IRspine was < 41.39 (βfemur = 0.008, βspine = 0.011, all P < 0.05). We also found that METS-IR was positively correlated with both FRAX scores in all female participants. However, METS-IR was positively correlated only with the 10-year hip fracture risk score in male participants with fractures. No significant association between METS-IR and a history of bone fractures.

CONCLUSIONS

In American non-diabetic adults, there is a correlation between elevated levels of METS-IR within the lower range and increased BMD as well as decreased risk of fractures, suggesting that METS-IR holds promise as a novel biomarker for guiding osteoporosis (OP) prevention. However, it is important to carefully balance the potential benefits and risks of METS-IR in OP.

Correlation between hearing impairment and the Triglyceride Glucose Index: based on a national cross-sectional study

Objective

Data from the National Health and Nutrition Examination Survey (NHANES) were used to assess the association between the triglyceride-glucose (TyG) index and hearing impairment (HI).

Methods

We used eight survey cycles from NHANES 2001-2012 and 2015-2018 to conduct this cross-sectional study. HI was designed as an dependent variable, and the TyG index was selected as an exposure factor (independent variable). The correlation between the two variables was assessed using multiple logistic regression. In order to assess whether there was a non-linear relationship between the TyG index and HI, the TyG index was distributed and a test for trend was conducted (P for trend), followed by smooth curve fitting (penalized spline) and generalized additive model (GAM) regression. We also performed a subgroup analysis to identify sensitive groups whose responses were clearly associated with independent variables.

Results

10,906 participants were finally included in the study, and those with a higher TyG index had a higher frequency of hearing impairment. There was a linear positive correlation between the TyG index and HI. For the low-frequency HI, however, this positive correlation was not statistically significant (OR = 1.05, 95% CI: 0.98, 1.14); however, it was more stable for the high-frequency HI (OR = 1.12, 95% CI: 1.03, 1.22). Additionally, as the TyG index increased, this positive association increased as well (P for trend = 0.05). The HPTA test showed a positive association with more severe HI (simultaneous) as the independent variable increased (OR = 1.14, 95% CI: 1.05-1.24), and this association was even more significant with increasing severity (P for trend 0.05). According to the subgroup analysis, the positive association between TyG index and high-frequency HI was more significant in females, 40-69 years old, without hypertension or diabetes, and when strict high-frequency HI was significant in males, females, 40-69 years old, with hypertension and diabetes.

Conclusion

Participants with a higher TyG index may have a higher risk of HI. TyG index and HI risk showed a linear relationship, which became even more significant when HPTA was included.

Higher visceral adiposity index was associated with an elevated prevalence of gallstones and an earlier age at first gallstone surgery in US adults: the results are based on a cross-sectional study

Objective

We sought to evaluate the association between visceral adiposity index (VAI) and the incidence of gallstones and the age at first gallstone surgery in adults in the United States.

Methods

We selected individuals from the National Health and Nutrition Examination Survey (NHANES) database from 2017 to 2020 and evaluated the association between VAI and gallstone incidence and age at first gallstone surgery using logistic regression analysis, subgroup analysis, and dose-response curves.

Results

A total of 7,409 participants aged >20 years were included in our study; 767 had a self-reported history of gallstones. After adjustment for all confounding factors, for each unit of VAI after Ln conversion, gallstone prevalence increased by 31% (OR = 1.31, 95% CI: 1.17, 1.48), while the first gallstone surgery was 1.97 years earlier (β = -1.97, 95% CI: -3.35, -0.42). The dose-response curves showed a positive correlation between VAI and gallstone prevalence. There was a negative correlation between increased VAI and age at first gallstone surgery.

Conclusion

A higher VAI is positively associated with the prevalence of gallstones and may lead to an earlier age at first gallstone surgery. This is worthy of attention, although causality cannot be established.

The metabolic score of insulin resistance is positively correlated with bone mineral density in postmenopausal patients with type 2 diabetes mellitus

The prevalence of type 2 diabetes mellitus (T2DM) complicated with osteoporosis (OP) is increasing yearly. Early prevention, detection and treatment of OP are important in postmenopausal patients with T2DM. This study aimed to explore the correlation between insulin resistance and bone mineral density (BMD), and OP in postmenopausal patients with T2DM. In this study, postmenopausal patients with T2DM who visited our hospital from January 2021 to March 2022 were divided into the OP group (n = 91) and non-OP group (n = 119) according to whether they were complicated with OP or not. The general data of patients, BMD, blood routine, glucose metabolism, lipid metabolism, liver and kidney function indexes were collected, and the homeostatic model assessment for IR (HOMA-IR), the triglyceride-glucose (TyG) index and the metabolic score for IR (METS-IR) were calculated. A weighted multivariate linear regression model assessed the correlation between insulin resistance (IR) related indexes and lumbar spine, femoral neck, and hip BMD. A weighted logistic regression model assessed the odds ratios (ORs) and 95% confidence intervals (95% CIs) for the association between the IR-related indexes and OP risk. The nonlinear relationship was also evaluated by smooth curve fitting (SCF) and a weighted generalized additive model (GAM). Moreover, the Receiver-operating characteristics (ROC) curve was used to analyze the predictive efficiency of METS-IR in postmenopausal patients with T2DM with OP. HOMA-IR, TyG, and METS-IR in the OP group were lower than those in the non-OP group (all P < 0.05). Weighted multiple linear regression after adjusting covariates showed that METS-IR was positively correlated with the lumbar spine, femoral neck, and hip BMD (β_METS-IR = 0.006,0.005,0.005, all P < 0.001). The results of weighted Logistic regression and GAM showed that when METS-IR < 44.5, each unit of increased METS-IR value was associated with a decreased OP risk of 12% (P = 0.002). When METS-IR ≥ 44.5, there was no significant correlation between METS-IR and the risk of OP (OR = 1.00, P = 0.934). Similar trends were not observed in HOMA-IR and TyG. The ROC suggested helpful discriminative power of the METS-IR index for T2DM. We confirmed that METS-IR, as a novel alternative marker of IR, had a positive association with BMD in postmenopausal patients with T2DM, and METS-IR was a protective factor for OP in a specific range.

The association of asthma duration with body mass index and Weight-Adjusted-Waist index in a nationwide study of the U.S. adults

BACKGROUNDS

The association between obesity and asthma has been of interest, but whether the duration of asthma has an effect on obesity is still limitedly studied.

AIM

The purpose of this study was to investigate the association between asthma duration and obesity-related indexes, where obesity-related indexes include Body mass index (BMI) and Weight-adjusted-waist index (WWI).

METHODS

Data from National Health and Nutrition Examination Survey (NHANES) 2009-2018 were obtained to conduct this cross-sectional study. Duration of asthma was used as the independent variable and obesity-related indexes as the response variables. Multiple linear regression was used to assess the association between the independent variable and the response variables, and subsequently smoothed curve fitting and threshold effect analysis were performed to clarify whether there was a nonlinear correlation between the independent variable and the response variables. Finally, subgroup analysis was conducted to find sensitive populations.

RESULTS

A total of 9170 participants were included in the analysis. Asthma duration was statistically different between the two groups when all participants were grouped by median WWI (Q1 < 11.65, Q2 ≥ 11.65) (P < 0.001), but not by median BMI (Q1 < 31.8, Q2 ≥ 31.8) (P = 0.130). There was a positive association between asthma duration and WWI [β = 0.016, 95% CI (0.016, 0.017)], but a negative one with BMI [β = - 0.098, 95% CI (- 0.112, - 0.085)], and the correlations between the independent and response variables became more pronounced with increasing asthma duration (P for trend < 0.01). In addition, there were nonlinear relationships between asthma duration with BMI and WWI (log likelihood ratio < 0.001), with the best valid inflection points for asthma duration being 2 years (with WWI as the response variable) and 3 years (with BMI as the response variable), respectively. In the subgroup analysis, the positive association between asthma duration and WWI was more pronounced in the participants who were male, aged less than 40 years, and had asthma onset before 12 years of age. In contrast, when BMI was used as the response variable, the negative association between it and asthma duration was more pronounced among participants of female, aged 60 years or older, and with asthma onset less than 12 years of age.

CONCLUSIONS

In US adults, asthma duration might cause changes in obesity-related indexes. Longer asthma duration might cause weight loss, but might increase the risk of abdominal obesity.

Association of METS-IR index with prevalence of gallbladder stones and the age at the first gallbladder stone surgery in US adults: A cross-sectional study

OBJECTIVE

The purpose of this study was to assess the correlation between the metabolic score for insulin resistance (METS-IR) index and gallbladder stoneprevalence in US adults, as well as the age at first gallbladder stone surgery.

METHODS

A logistic regression analysis, subgroup analysis, and dose-response curve were computed for participants in the 2017-2018 National Health and Nutrition Examination Survey (NHANES) to assess the relationship between the METS-IR index and gallbladder stone prevalence and age at first surgery for gallbladder stones.

RESULTS

This study ultimately included 9452 participants aged >20 years, of whom 534 self-reported a history of gallbladder stones, and after adjusting for all confounders, each unit increase in METS-IR index was associated with a 3.3% increase in gallbladder stone prevalence (OR= 1.033, 95% CI: 1.0258, 1.0403) along with an earlier age at first gallbladder stone surgery 0.26 years (β= -0.26, 95% CI: -0.35, -0.17), stratified analysis showed that increased METS-IR index was associated with increased prevalence of gallbladder stones in all subgroups, and the dose-response curve showed a positive linear correlation between METS-IR index and prevalence of gallbladder stones, while a negative linear correlation was observed between increased METS-IR index and age at first gallbladder stone There was a negative linear correlation between age at surgery.

CONCLUSION

The METS-IR index has been positively associated with gallbladder stone prevalence, thereby contributing to age at first surgery for gallbladder stones. However, the causal relationship between the METS-IR and gallbladder stones cannot be concluded.