Association of non-insulin-based insulin resistance indices with disease severity and adverse outcome in idiopathic pulmonary arterial hypertension: a multi-center cohort study
An erratum to this article was published (Cardiovasc Diabetol, 9 Jun 2025 ↗)
Authors' conclusion
IR is associated with the severity and long-term prognosis of IPAH. TyG-BMI and METS-IR can independently predict clinical worsening events, while METS-IR also provide incremental predictive performance beyond the ESC risk stratification.
Study context
- Population
- Consecutive patients with idiopathic pulmonary arterial hypertension (IPAH), January 2015–December 2022
- Participants
- 602 patients
- Exposure
- Non-insulin-based insulin resistance (IR) indices and adverse outcomes
- Outcome
- Long-term adverse outcomes: all-cause death or worsening condition
- Follow-up
- Mean 3.6 years'
Methodological detailsmulticenter, consecutive participants
- Multicenter
- Consecutive participants
Main finding
As reported in the abstract
Participants with all-cause death or worsening condition
214
Triglyceride-glucose-body mass index (TyG-BMI) index, HR per 1.0-SD increment
1.179
95% CI 1.020, 1.363P = 0.026
Metabolic score for IR (METS-IR), HR per 1.0-SD increment
1.169
95% CI 1.016, 1.345P = 0.030
Observational data: associations, not effects.
Further findings
TG/HDL-C ratio and METS-IR by risk category (low to intermediate-low vs high to intermediate-high risk)
- TG/HDL-C ratio, mean ± SD, 2.9 ± 1.7 vs. 3.3 ± 2.1, P = 0.003; significantly increased in high to intermediate-high risk
- METS-IR, mean ± SD, 34.5 ± 6.7 vs. 36.4 ± 7.5, P < 0.001; significantly increased in high to intermediate-high risk
Correlation with IPAH severity
- IR indices correlated with variables reflecting IPAH severity, such as cardiac index and stroke volume index
Incremental prediction beyond European Society of Cardiology (ESC) risk score
- Addition of TG/HDL-C ratio and METS-IR significantly improved reclassification and discrimination beyond the ESC risk score
Original publication
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