Metabolic Score for Insulin Resistance, a novel score to evaluate insulin sensitivity, is associated with the urinary albumin-to-creatinine ratio in Chinese adults: A cross-sectional REACTION study.

Aims/introduction: The Metabolic Score for Insulin Resistance (METS-IR) is a novel non-insulin-based metabolic index used as a substitution marker of insulin resistance. However, whether METS-IR is associated with the urinary albumin-to-creatinine ratio (UACR) is not well known. Therefore, we explored the associations between METS-IR and UACR, and compared the discriminative ability of METS-IR and its components for elevated UACR.

Materials And Methods: This study included 37,290 participants. METS-IR was calculated as follows: (Ln[2 × fasting blood glucose + fasting triglyceride level] × body mass index) / (Ln [high-density lipoprotein cholesterol]). Participants were divided into four groups on the basis of METS-IR: <25%, 25-49%, 50-74% and ≥75%. Logistic regression analyses were carried out to determine the associations between METS-IR versus its components (fasting blood glucose, triglyceride level, body mass index and high-density lipoprotein cholesterol) with UACR.

Results: Participants with the highest quartile METS-IR presented a more significant trend toward elevated UACR than toward its components (odds ratio 1.260, 95% confidence interval 1.152-1.378, P < 0.001 in all participants; odds ratio 1.321, 95% confidence interval 1.104-1.579, P = 0.002 in men; odds ratio 1.201, 95% confidence interval 1.083-1.330, P < 0.001 in women). There were significant associations between METS-IR and UACR in younger participants (aged <65 years for women and aged 55-64 years for men). Increased METS-IR was significantly associated with UACR in men with fasting blood glucose ≥5.6 or postprandial blood glucose ≥7.8 mmol/L and systolic blood pressure ≥120 or diastolic blood pressure ≥80 mmHg. The relationships were significant in women with diabetes and hypertension.

Conclusions: Increased METS-IR was significantly associated with elevated UACR, its discriminative power for elevated UACR was superior to that of its components.