In patients with type 2 diabetes, WHR and serum uric acid levels are significantly correlated with insulin resistance status, and may provide preliminary insights into the metabolic abnormalities associated with insulin resistance in patients with type 2 diabetes.
Abstract
Background: Type 2 diabetes mellitus (T2DM) is one of the most common chronic metabolic diseases worldwide, and insulin resistance is the core pathophysiological basis for its development. This study aims to explore the relationship between various metabolic-related indicators and insulin resistance in patients with T2DM, and to analyze the correlation between obesity indicators, glucose and lipid metabolism indicators, and serum uric acid with insulin resistance, providing a reference for clinical identification of insulin resistance.Methods: This was a single-center retrospective study, consecutively enrolling 263 patients with type 2 diabetes who received treatment at our center between August 2022 and August 2025. Patients were divided into a non-insulin-resistant group (n = 211) and an insulin-resistant group (n = 52) based on the Homeostasis Model Assessment of Insulin Resistance (HOMA-IR). Baseline clinical data and laboratory parameters were collected, including body mass index, waist-to-hip ratio, fasting blood glucose, 2-hour postprandial blood glucose, lipid profile, glycated hemoglobin, fasting C-peptide, and serum uric acid. The triglyceride-glucose (TyG) index was also calculated. Logistic regression analysis was performed to screen for metabolic indicators associated with insulin resistance, and receiver operating characteristic (ROC) curve analysis was then conducted to evaluate the discriminative ability of these indicators for insulin resistance.Results: Patients in the insulin resistance group had significantly higher levels of body mass index (BMI), waist-to-hip ratio (WHR), triglycerides, fasting blood glucose, TyG index, fasting C-peptide, glycated hemoglobin (HbA1c), systolic blood pressure, diastolic blood pressure, and serum uric acid than the non-insulin resistance group (all p < 0.05), and a higher proportion of patients with hypertension (65.38% vs. 46.45%, p = 0.014). Multivariate logistic regression analysis showed that WHR, TyG index, fasting C-peptide, and serum uric acid were independently associated with insulin resistance. The area under the curve (AUC) for assessing insulin resistance using the combined indicators was 0.81 (95% CI: 0.74–0.88), with a sensitivity of 79.0% and a specificity of 71.0%.Conclusion: In patients with type 2 diabetes, WHR and serum uric acid levels are significantly correlated with insulin resistance status. These indicators reflect various metabolic characteristics from different perspectives, including obesity, glucose and lipid metabolism, and pancreatic β-cell function, and may provide preliminary insights into the metabolic abnormalities associated with insulin resistance in patients with type 2 diabetes.
Background: Childhood obesity is increasingly recognized as a major public health concern and is associated with insulin resistance, the underlying mechanism behind many components of metabolic syndrome. Early detection of insulin resistance may provide an opportunity for timely intervention. The homeostasis model assessment of insulin resistance (HOMA-IR) is a simple and validated index used to quantify insulin resistance.
Methods: We conducted a hospital-based cross-sectional study among 165 children attending the outpatient department or admitted under the Department of Paediatrics at a tertiary care centre in southern India. Detailed history, clinical examination, anthropometric measurements, and laboratory investigations were performed. Insulin resistance was assessed using HOMA-IR, with a value ≥2.5 considered indicative of insulin resistance.
Results: Insulin resistance (HOMA-IR≥2.5) was present in 124 (75.2%) children. Significant associations were observed between insulin resistance and acanthosis nigricans, and a positive family history of type 2 diabetes mellitus. Although 78.2% of children had normal fasting blood glucose levels, a substantial proportion exhibited insulin resistance. Mean total cholesterol and triglyceride levels were 180.2±25.9 mg/dl and 105±34.5 mg/dl, respectively, and both showed significant positive correlations with HOMA-IR (r=0.417 and r=0.511, respectively; p<0.01).
Conclusions: Insulin resistance is highly prevalent among overweight and obese children and may precede overt abnormalities in blood glucose. Reliance on fasting blood glucose alone may underestimate the burden of metabolic dysfunction. Early identification using HOMA-IR may facilitate timely lifestyle interventions during a potentially reversible stage and help prevent future metabolic complications.
Devi Poikayil Saji, R. S. Nair, Rino Rakesh· International Journal of Con...· 0 citations
BACKGROUND
Childhood obesity is strongly associated with insulin resistance (IR) and related metabolic complications. However, the optimal surrogate marker for identifying IR in pediatric populations remains unclear.
OBJECTIVE
To evaluate the diagnostic performance of commonly used IR indices and to investigate their association with metabolic outcomes in children and adolescents with obesity.
METHODS
This retrospective study included 899 children and adolescents with obesity followed at a tertiary pediatric endocrinology center over a 10-year period. IR was defined based on oral glucose tolerance test (OGTT) findings. The diagnostic performance of the fasting glucose-to-insulin ratio (FGIR), quantitative insulin sensitivity check index (QUICKI) and the homeostatic model assessment for insulin resistance (HOMA-IR) was assessed using receiver operating characteristic (ROC) curve analysis. Associations between IR, metabolic syndrome (MS), dysglycemia, hepatic steatosis, and biochemical parameters were analyzed. Multivariate logistic regression was performed to identify independent predictors.
RESULTS
HOMA-IR demonstrated the highest diagnostic performance for identifying IR (AUC: 0.711 in girls and 0.700 in boys), outperforming FGIR and QUICKI. Among pubertal participants, the optimal HOMA-IR cut-off values for predicting OGTT-defined insulin resistance were 4.22 in girls and 4.18 in boys. IR was present in 76.3% of participants and was associated with an unfavorable metabolic profile, including higher rates of dysglycemia and hepatic steatosis. Hepatic steatosis was detected in 63.5% of children and was significantly more common in boys. In multivariate analysis, male sex, BMI-SDS, and ALT were independent predictors of hepatic steatosis, whereas IR parameters were not independently associated. TSH levels were higher in IR and MS groups but remained within the normal range.
CONCLUSION
HOMA-IR is a reliable and practical marker for identifying IR in children with obesity. While IR is associated with multiple metabolic disturbances, adiposity and liver-related markers appear to play a more dominant role in predicting hepatic steatosis. A comprehensive metabolic evaluation, including both fasting indices and dynamic tests, is essential for early risk stratification in pediatric obesity.
B. Eroğlu Filibeli, Gülümay Vural Topaktaş, J. Yildirim et al.· BMC Pediatrics· 0 citations
The findings suggest that the TyG index and vitamin D status are associated with cardiometabolic risk factors; however, the cross-sectional design precludes causal inference, and prospective studies are needed to confirm these associations.
Sweety Kumari, A. Batta, Manju Sharma et al.· International Journal of Hea...· 0 citations
Objective Insulin resistance (IR) constitutes a central pathophysiological mechanism underlying a spectrum of chronic metabolic disorders. The Metabolic Score for Insulin Resistance (METS-IR), which integrates fasting blood glucose (FBG), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), and body mass index (BMI), serves as a simple, cost-effective surrogate marker for IR. However, its associations with type 2 diabetes mellitus (T2DM), cancer, and all-cause mortality remain to be systematically synthesized. This study aims to systematically evaluate its clinical prognostic value. Methods We systematically searched PubMed, EMBASE, and Web of Science for prospective or retrospective cohort studies evaluating the associations of baseline METS-IR with incident T2DM, cancer, or all-cause mortality. Pooled hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using random-effects models, and linear and nonlinear dose-response meta-analyses were performed. Heterogeneity, robustness, and publication bias were additionally assessed. Results A total of 23 cohort studies were included. For T2DM (6 studies), the highest METS-IR category was associated with a substantially elevated risk compared with the lowest category (HR = 4.03, 95% CI: 2.57–6.33), and per 1-standard deviation (1-SD) increment in METS-IR corresponded to a 48% higher risk (HR = 1.48, 95% CI: 1.24–1.77); dose-response analysis revealed a significant nonlinear increasing relationship (P for nonlinearity< 0.001). For cancer (5 studies), per 1-SD increment in METS-IR was associated with a 21% higher risk of cancer (HR = 1.21, 95% CI: 1.10–1.34); dose-response analysis indicated a significant nonlinear association (P for nonlinearity = 0.042). For all-cause mortality (13 studies), per 1-SD rise in METS-IR was linked to an 8% increased risk of all-cause death (HR = 1.08, 95% CI: 1.03–1.14); dose-response analysis demonstrated an overall linear increasing trend (P for linearity = 0.029), with each 20-unit increase in METS-IR associated with an approximately 2.8% higher risk of all-cause mortality (HR = 1.028, 95% CI: 1.004–1.056). Conclusions Elevated METS-IR levels are significantly associated with a nonlinear, progressive increase in the risk of incident T2DM. Its associations with cancer and all-cause mortality are weaker and more complex yet still exhibit consistent directional trends. METS-IR represents a convenient, readily applicable tool for early identification of metabolic risk using routine clinical parameters; however, its prognostic value for cancer and all-cause mortality merits further validation in large-scale, long-term follow-up studies. Systematic review registration PROSPERO, identifier CRD420261293948.
Fengwei Guo, Hui Liu, Junyi Sun et al.· Frontiers in Endocrinology· 0 citations
Aims : Insulin resistance (IR) plays a pivotal role in the onset and progression of coronary artery disease (CAD). This study aims to assess the efficacy and clinical utility of four non-insulin-based IR indices—Triglyceride-Glucose (TyG) index, Metabolic Score for Insulin Resistance (METS-IR), Triglyceride-Glucose-Body Mass Index (TyG-BMI), and Triglyceride to High-Density Lipoprotein Cholesterol ratio (TG/HDL-C)—in predicting prognosis in patients with newly diagnosed CAD. Methods This retrospective analysis included 890 patients with newly diagnosed CAD enrolled between January 2019 and June 2022. LASSO penalized regression was applied for covariate selection to mitigate overfitting (events-per-variable ratio ≈ 13.9), and Firth's penalized maximum likelihood estimation was performed as a sensitivity analysis. Multivariable Cox models and restricted cubic spline analyses examined associations between the four non-insulin-based IR indices and major adverse cardiovascular events (MACEs). The proportional hazards assumption was verified using Schoenfeld residual tests, and Bonferroni correction was applied for multiple comparisons (α = 0.0125). Receiver operating characteristic curves were plotted, and the incremental prognostic performance of each IR index for MACEs was assessed using the area under the ROC curve (AUC), C-statistics, net reclassification index (NRI), and integrated discrimination improvement (IDI). Kaplan–Meier analysis was used to evaluate the relationship between IR indices and clinical outcomes. Results Over a median follow-up of 26.5 months, the overall incidence of MACEs was 10.9%. TyG index (HR = 1.627, 95% CI: 1.228–2.145), TyG-BMI (HR = 1.019, 95% CI: 1.014–1.023), TG/HDL-C (HR = 1.127, 95% CI: 1.055–1.195), and METS-IR (HR = 1.104, 95% CI: 1.080–1.129) were all identified as independent risk factors for MACEs. METS-IR showed the highest incremental prognostic value (C-statistic = 0.779, IDI = 0.082, NRI = 0.356, P < 0.001). Log-rank tests indicated significantly higher MACEs rates in patients with higher IR indices (P < 0.01). Conclusions TyG index, TyG-BMI, TG/HDL-C ratio, and METS-IR are independently associated with MACEs in patients with newly diagnosed CAD, with METS-IR demonstrating the highest incremental predictive performance.
Meng Sun, Lulin Chen, Dandan Li et al.· Frontiers in Cardiovascular...· 0 citations
Patients with type 2 diabetes demonstrate significant dyslipidemia, elevated atherogenic indices, and increased insulin resistance, and Atherogenic index of plasma emerged as a reliable marker of cardiovascular risk, highlighting the importance of routine evaluation of lipid profiles and atherogenic indices for early detection and prevention of cardiovascular complications in type 2 diabetes.
M. Shrewastwa, S. Bk, S. Karn· Journal of Nepalgunj Medical...· 0 citations
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