Korean J Fam Med.
2024 Nov;45(6):324-330. 10.4082/kjfm.23.0138.
Non-Insulin-Based Indices of Insulin Resistance for Predicting Incident Albuminuria: A Nationwide Population-Based Study
- Affiliations
-
- 1Department of Family Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
- 2Department of Clinical Research Design & Evaluation, Samsung Advanced Institute for Health Science & Technology, Sungkyunkwan University, Seoul, Korea
- 3Biostatistics Collaboration Unit, Department of Research Affairs, Yonsei University College of Medicine, Seoul, Korea
- KMID: 2560967
- DOI: http://doi.org/10.4082/kjfm.23.0138
Abstract
- Background
Studies have shown that incident albuminuria is associated with insulin resistance (IR); however, an IR marker that best predicts the prevalence of albuminuria has not yet been established. This study explored the association between IR and incident albuminuria using various IR indices, including the homeostasis model assessment of IR (HOMA-IR), metabolic score for IR (METS-IR), and triglyceride-glucose (TyG) index, and compared their predictive abilities for the prevalence of albuminuria.
Methods
A total of 4,982 Korean adults from the 2019 Korea National Health and Nutritional Examination Survey were analyzed. The odds of albuminuria were determined using the quartiles of the IR indices. Receiver operating characteristic (ROC) curves were used to calculate the area under the ROC curve and predictability. The cutoff values for albuminuria detection were also computed.
Results
An increase in the quartiles of all three IR indices was associated with incident albuminuria, even after full adjustment for covariates (HOMA-IR: odds ratio [OR], 1.906; 95% confidence interval [CI], 1.311–2.772; P=0.006; METS-IR: OR, 2.236; 95% CI, 1.353–3.694; P=0.002; TyG index: OR, 1.757; 95% CI, 1.213–2.544; P=0.003). The area under the ROC curve for incident albuminuria based on the HOMA-IR, METS-IR, and TyG indices was 0.594 (95% CI, 0.568–0.619), 0.633 (95% CI, 0.607–0.659), and 0.631 (95% CI, 0.606–0.656), respectively. The optimal cutoff values for predicting albuminuria were 2.38, 35.38, and 8.72 for the HOMA-IR, METS-IR, and TyG indices, respectively.
Conclusion
The METS-IR and TyG indices outperformed HOMA-IR in predicting incident albuminuria.
