Lipids & metabolic liver disease
Joint assessment of insulin resistance surrogate indices and basal metabolic rate for primary prevention of cardiometabolic multimorbidity: evidence from the China Health and Retirement Longitudinal Study (2011–2020)
Authors' conclusion
IR surrogate indices and BMR independently and jointly predicted the risk of CMM, with IR pathways substantially mediating the effect of BMR. The combined assessment of these parameters may improve CMM risk stratification and guide primary prevention strategies.
Study context
- Population
- Participants of the 2011–2020 China Health and Retirement Longitudinal Study (CHARLS) survey waves, China
- Participants
- 7,204 participants
- Exposure
- High vs low IR surrogate indices and basal metabolic rate (BMR), stratified by median
- Outcome
- Incident cardiometabolic multimorbidity (CMM)
- Follow-up
- Median 9 years
Methodological detailspopulation-based, China Health and Retirement Longitudinal Study (CHARLS) 2011–2020
- Population-based
- China Health and Retirement Longitudinal Study (CHARLS) 2011–2020
Main finding
As reported in the abstract
Incident CMM
Estimate (95% CI)
High IR + high BMRvs Low IR + low BMR
HR (TyG) 2.13(1.73–2.63)
High IR + high BMRvs Low IR + low BMR
HR (eGDR) 1.93(1.57–2.36)
High IR + high BMRvs Low IR + low BMR
HR (METS-IR) 1.92(1.61–2.29)
- Developed cardiometabolic multimorbidity (CMM) (overall cohort)
- 1103 (15.31%)
Observational data: associations, not effects.
Further findings
Prediction of CMM after adding IR indices and BMR to baseline model
- Triglyceride-glucose (TyG): AUC 0.759, net reclassification improvement (NRI) 0.371, integrated discrimination improvement (IDI) 0.017
- all P < 0.001
- Estimated glucose disposal rate (eGDR): AUC 0.753, NRI 0.330, IDI 0.012
- all P < 0.01
- Metabolic score for insulin resistance (METS-IR): AUC 0.747, NRI 0.170, IDI 0.004
- all P < 0.01
Mediation and interaction
- All IR indices significantly mediated the BMR–CMM association; bidirectional mediation between BMR and TyG
- No significant additive or multiplicative interactions
Original publication
Joint assessment of insulin resistance surrogate indices and basal metabolic rate for primary prevention of cardiometabolic multimorbidity: evidence from the China Health and Retirement Longitudinal Study (2011–2020). Cardiovasc Diabetol. Published 12 January 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →