Insulin-based or non-insulin-based insulin resistance indicators and risk of long-term cardiovascular and all-cause mortality in the general population: A 25-year cohort study
Authors' conclusion
Fasting insulin, HOMA-IR, TyG-BMI, and QUICKI may indicate mortality risk in diabetes and non-diabetes populations, with TyG and the hypertriglyceridemic-waist phenotype showing particular relevance for individuals with diabetes. Further studies are needed to validate these findings and determine their broader applicability.
Study context
- Population
- General population, Third National Health and Nutrition Examination Survey; mortality via National Death Index until December 31, 2019
- Participants
- 13,909 participants
- Exposure
- Higher vs lower levels of insulin-based and non-insulin-based insulin resistance (IR) indicators
- Outcome
- All-cause mortality and cardiovascular mortality
- Follow-up
- median 25-year follow-up
Methodological detailspopulation-based, National Health and Nutrition Examination Survey
- Population-based
- National Health and Nutrition Examination Survey
Main finding
As reported in the abstract
All-cause mortality (5,306 events), multivariate-adjusted
- Higher insulin, HR [95% CI]
- 1.07 [1.02;1.13]
- Higher homeostasis model assessment of IR (HOMA-IR), HR [95% CI]
- 1.08 [1.03;1.13]
- Higher insulin-to-glucose ratio (IGR), HR [95% CI]
- 1.05 [1.00;1.11]
- Higher triglyceride glucose (TyG), HR [95% CI]
- 1.07 [1.00;1.14]
- Higher TyG-body mass index (TyG-BMI), HR [95% CI]
- 1.24 [1.02;1.51]
- Lower QUICKI, HR [95% CI]
- 0.91 [0.86-0.96]
Observational data: associations, not effects.
Further findings
All-cause mortality by DM status: insulin, HOMA-IR, TyG-BMI, QUICKI
- Higher insulin, HOMA-IR, TyG-BMI and lower QUICKI significantly associated with increased risk in both DM and non-DM populations
- all P for interaction > 0.05
All-cause mortality in DM: higher TyG
- aHR [95% CI] in DM; association not seen without DM
- 1.17 [1.09;1.26], P for interaction = 0.018
All-cause mortality in DM: hypertriglyceridemic-waist phenotype
- aHR [95% CI] in DM; association not seen without DM
- 1.26 [1.08;1.46], P for interaction = 0.047
Cardiovascular death
- Similar results observed between the IR indicators and cardiovascular death
Original publication
Insulin-based or non-insulin-based insulin resistance indicators and risk of long-term cardiovascular and all-cause mortality in the general population: A 25-year cohort study. Diabetes Metab. Published 8 August 2024. doi:10.
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