Metabolic score for insulin resistance is associated with adverse cardiovascular events in patients with type 2 diabetes

Table 1 Baseline characteristics of participants by quartiles of metabolic score for insulin resistance, n (%)

Outcome	Q1 (n = 2548)	Q2 (n = 2547)	Q3 (n = 2548)	Q4 (n = 2548)	P value
METS-IR, mean ± SD	41.19 ± 4.23	50.39 ± 2.09	57.78 ± 2.33	69.71 ± 6.66	< 0.001
Age (years), mean ± SD	64.26 ± 7.12	63.39 ± 6.64	62.47 ± 6.37	61.14 ± 5.98	< 0.001
Sex					0.002
Male	1511 (59.30)	1640 (64.39)	1570 (61.62)	1544 (60.60)
Female	1037 (40.70)	907 (35.61)	978 (38.38)	1004 (39.40)
Race					< 0.001
White	1152 (45.21)	1512 (59.36)	1739 (68.25)	1965 (77.12)
Non-white	1396 (54.79)	1035 (40.64)	809 (31.75)	583 (22.88)
Education					< 0.001
Less than high school graduate	434 (17.05)	413 (16.22)	373 (14.64)	281 (11.04)
High school grad	671 (26.37)	667 (26.19)	673 (26.42)	679 (26.68)
Some college or technical school	690 (27.11)	814 (31.96)	869 (34.12)	968 (38.04)
College graduate or more	750 (29.47)	653 (25.64)	632 (24.81)	617 (24.24)
CVD history	825 (32.38)	898 (35.26)	927 (36.38)	933 (36.62)	0.005
Duration of diabetes (years), mean ± SD	12.05 ± 8.14	11.06 ± 7.76	10.26 ± 7.17	9.83 ± 7.07	< 0.001
Previous hypertension	1861 (73.04)	1901 (74.64)	1925 (75.55)	1993 (78.22)	0.008
Proteinuria	429 (16.84)	483 (18.96)	505 (19.83)	610 (23.94)	< 0.001
Heart failure	81 (3.18)	96 (3.77)	126 (4.95)	184 (7.22)	< 0.001
Depression	425 (16.68)	535 (21.01)	628 (24.66)	824 (32.35)	< 0.001
Living alone	2043 (80.18)	2034 (79.89)	2031 (79.71)	2018 (79.23)	0.861
Smoking					< 0.001
Yes	1325 (52.00)	1513 (59.40)	1549 (60.79)	1547 (60.71)
No	1223 (48.00)	1034 (40.60)	999 (39.21)	1001 (39.29)
Alcohol					< 0.001
Yes	659 (25.86)	661 (25.96)	588 (23.10)	524 (20.58)
No	1889 (74.14)	1885 (74.04)	1958 (76.90)	2022 (79.42)
BMI (kg/m2), mean ± SD	26.36 ± 2.76	30.38 ± 2.67	33.76 ± 3.16	38.41 ± 3.68	< 0.001
SBP (mmHg), mean ± SD	137.20 ± 16.95	136.49 ± 17.25	135.99 ± 17.17	135.73 ± 17.03	0.013
DBP (mmHg), mean ± SD	73.20 ± 10.56	74.48 ± 10.58	75.49 ± 10.52	76.38 ± 10.74	< 0.001
Heart rate (bpm), mean ± SD	71.65 ± 11.67	71.78 ± 11.58	73.27 ± 11.66	73.99 ± 11.94	< 0.001
FPG (mg/dL), mean ± SD	157.90 ± 54.45	170.56 ± 52.95	178.76 ± 53.52	193.51 ± 57.66	< 0.001
HbA1C (%), mean ± SD	8.23 ± 1.08	8.23 ± 1.02	8.30 ± 1.02	8.45 ± 1.09	< 0.001
TC (mg/dL), mean ± SD	181.47 ± 39.36	181.10 ± 39.96	183.22 ± 42.08	187.40 ± 45.44	< 0.001
TG (mg/dL), mean ± SD	125.87 ± 72.81	166.08 ± 92.14	201.16 ± 130.08	267.11 ± 215.59	< 0.001
LDL-C (mg/dL), mean ± SD	106.91 ± 33.05	105.91 ± 33.56	104.30 ± 33.92	102.47 ± 34.94	< 0.001
HDL-C (mg/dL), mean ± SD	49.53 ± 13.12	42.51 ± 10.23	39.88 ± 9.46	35.56 ± 8.46	< 0.001
eGFR (mL/minute/1.73 m2), mean ± SD	91.53 ± 30.19	90.70 ± 27.47	90.89 ± 24.57	91.05 ± 26.00	0.727
ALT (mg/dL), mean ± SD	25.12 ± 13.13	27.47 ± 19.14	28.37 ± 15.98	29.38 ± 15.63	< 0.001
Medications
ARB/ACEI	1665 (65.35)	1790 (70.28)	1758 (69.00)	1850 (72.61)	< 0.001
CCB	484 (19.00)	468 (18.37)	484 (19.00)	516 (20.25)	0.382
Bate blockers	604 (23.75)	720 (28.36)	824 (32.44)	917 (36.07)	< 0.001
Biguanides	1563 (61.34)	1646 (64.63)	1686 (66.20)	1623 (63.70)	0.003
Thiazolidinediones	545 (21.39)	507 (19.91)	590 (23.16)	604 (23.70)	0.004
Sulfonylureas	1399 (54.91)	1354 (53.16)	1353 (53.12)	1339 (52.55)	0.363
Insulins	793 (31.12)	882 (34.63)	888 (34.85)	999 (39.21)	< 0.001
Statins	1631 (64.31)	1638 (64.67)	1657 (65.21)	1539 (60.54)	0.002
Aspirin	1326 (52.31)	1381 (54.54)	1440 (56.76)	1402 (55.20)	0.015
Cholesterol absorption inhibitors	51 (2.01)	53 (2.09)	49 (1.93)	54 (2.13)	0.962
MACEs	402 (15.78)	418 (16.41)	482 (18.92)	510 (20.02)	< 0.001
CVD mortality	147 (5.77)	124 (4.87)	176 (6.91)	216 (8.48)	< 0.001
Non-fatal MI	203 (7.97)	228 (8.95)	241 (9.46)	258 (10.13)	0.054
Non-fatal stroke	103 (4.04)	125 (4.91)	130 (5.10)	126 (4.95)	0.276
Total mortality	448 (17.58)	448 (17.59)	491 (19.27)	556 (21.82)	< 0.001
Congestive heart failure	124 (4.87)	132 (5.18)	196 (7.69)	239 (9.38)	< 0.001
Major CHD	379 (14.87)	426 (16.73)	495 (19.43)	544 (21.35)	< 0.001

METS-IR: Metabolic score for insulin resistance; CVD: Cardiovascular disease; BMI: Body mass index; SBP: Systolic blood pressure; DBP: Diastolic blood pressure; FPG: Fasting plasma glucose; HbA1C: Hemoglobin A1c; TC: Total cholesterol; TG: Triglycerides; LDL-C: Low-density lipoprotein cholesterol; HDL-C: High-density lipoprotein cholesterol; eGFR: Estimated glomerular filtration rate; ALT: Alanine aminotransferase; ARB: Angiotensin receptor blocker; ACEI: Angiotensin converting enzyme inhibitors; CCB: Calcium channel blockers; MACEs: Major adverse cardiovascular events; MI: Myocardial infarction; CHD: Coronary heart disease.