Association Between the Metabolic Score for Insulin Resistance and
                    Hypertension in Adults: A Meta-Analysis

Kunrui Rao; Jun Yang; Mengbo Wu; Huang Zhang; Xiangtao Zhao; Yifei Dong

doi:10.1055/a-2010-2452

Hormone and Metabolic Research, Table of Contents

Horm Metab Res 2023; 55(04): 256-265
DOI: 10.1055/a-2010-2452

Original Article: Endocrine Care

Association Between the Metabolic Score for Insulin Resistance and Hypertension in Adults: A Meta-Analysis

Kunrui Rao

¹Department of Cardiovascular Medicine, Nanchang University Second Affiliated Hospital, Nanchang, China

,

Jun Yang

²Department of Cardiovascular Medicine, Nanchang First Hospital, Nanchang, China

,

Mengbo Wu

¹Department of Cardiovascular Medicine, Nanchang University Second Affiliated Hospital, Nanchang, China

,

Huang Zhang

¹Department of Cardiovascular Medicine, Nanchang University Second Affiliated Hospital, Nanchang, China

,

Xiangtao Zhao

¹Department of Cardiovascular Medicine, Nanchang University Second Affiliated Hospital, Nanchang, China

,

Yifei Dong

¹Department of Cardiovascular Medicine, Nanchang University Second Affiliated Hospital, Nanchang, China

³Key Laboratory of Molecular Biology in Jiangxi Province, Nanchang University Second Affiliated Hospital, Nanchang, China

› Author Affiliations

Abstract

The metabolic score for insulin resistance (METS-IR) is a recently developed parameter for screening of metabolic disorder. However, the association between METS-IR and risk of hypertension in general adult population remains not fully determined. A meta-analysis was therefore performed. Observational studies evaluating the association between METS-IR and hypertension in adults were retrieved by searching PubMed, Embase, and Web of Science databases from inception to October 10, 2022. A random-effects model, which incorporates the potential influence of heterogeneity, was used to pool the results. Eight studies with 305 341 adults were included in the meta-analysis, and 47 887 (15.7%) of them had hypertension. Pooled results showed that a higher METS-IR was associated with hypertension after adjusting for multiple conventional risk factors [relative risk (RR) for highest versus lowest category of METS-IR: 1.67, 95% confidence interval (CI): 1.53 to 1.83, p<0.001, I2=8%]. The results were consistent in subgroup analyses according to study design, source of the cohort, age, sex, body mass index of the participants, and quality scores of the study (p for subgroup difference all>0.05). Results of meta-analysis with METS-IR analyzed in continuous variables also showed that METS-IR was associated with the risk of hypertension (RR for 1-unit increment of METS-IR: 1.15, 95% CI: 1.08 to 1.23, p<0.001, I2=79%). In conclusion, a high METS-IR is associated with hypertension in general adult population. Measuring METS-IR may be useful for screening participants at high risk of hypertension.

Key words

metabolic score for insulin resistance - hypertension - risk - general population - meta-analysis

Full Text

References

References
1 Mills KT, Stefanescu A, He J. The global epidemiology of hypertension. Nat Rev Nephrol 2020; 16: 223-237
2 Tsao CW, Aday AW, Almarzooq ZI. et al. Heart disease and stroke statistics-2022 update: a report from the American heart association. Circulation 2022; 145: e153-e639
3 Zhou B, Perel P, Mensah GA. et al. Global epidemiology, health burden and effective interventions for elevated blood pressure and hypertension. Nat Rev Cardiol 2021; 18: 785-802
4 Kawabe H, Azegami T, Takeda A. et al. Features of and preventive measures against hypertension in the young. Hypertens Res 2019; 42: 935-948
5 Maranta F, Spoladore R, Fragasso G. Pathophysiological mechanisms and correlates of therapeutic pharmacological interventions in essential arterial hypertension. Adv Exp Med Biol 2017; 956: 37-59
6 Tagi VM, Mainieri F, Chiarelli F. Hypertension in patients with insulin resistance: etiopathogenesis and management in children. Int J Mol Sci 2022; 23(10): 5814
7 Brosolo G, Da Porto A, Bulfone L. et al. Insulin resistance and high blood pressure: mechanistic insight on the role of the kidney. Biomedicines 2022; 10(10): 2374
8 Kim JK. Hyperinsulinemic-euglycemic clamp to assess insulin sensitivity in vivo. Methods Mol Biol 2009; 560: 221-238
9 Muniyappa R, Lee S, Chen H. et al. Current approaches for assessing insulin sensitivity and resistance in vivo: advantages, limitations, and appropriate usage. Am J Physiol Endocrinol Metab 2008; 294: E15-E26
10 Bello-Chavolla OY, Almeda-Valdes P, Gomez-Velasco D. et al. METS-IR, a novel score to evaluate insulin sensitivity, is predictive of visceral adiposity and incident type 2 diabetes. Eur J Endocrinol 2018; 178: 533-544
11 Zhang M, Liu D, Qin P. et al. Association of metabolic score for insulin resistance and its 6-year change with incident type 2 diabetes mellitus. J Diabetes 2021; 13: 725-734
12 Cai XT, Zhu Q, Liu SS. et al. Associations between the metabolic score for insulin resistance index and the risk of type 2 diabetes mellitus among non-obese adults: insights from a population-based cohort study. Int J Gen Med 2021; 14: 7729-7740
13 Page MJ, Moher D, Bossuyt PM. et al. PRISMA 2020 explanation and elaboration: updated guidance and exemplars for reporting systematic reviews. BMJ 2021; 372: n160
14 Page MJ, McKenzie JE, Bossuyt PM. et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 2021; 372: n71
15 Higgins J, Thomas J, Chandler J. et al. Cochrane handbook for systematic reviews of interventions version 6.2. The Cochrane Collaboration. 2021 www.training.cochrane.org/handbook
16 Wells GA, Shea B, O'Connell D. et al. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. 2010 http://www.ohri.ca/programs/clinical_epidemiology/oxford.asp
17 Ziff OJ, Lane DA, Samra M. et al. Safety and efficacy of digoxin: systematic review and meta-analysis of observational and controlled trial data. BMJ 2015; 351: h4451
18 Higgins JP, Thompson SG. Quantifying heterogeneity in a meta-analysis. Stat Med 2002; 21: 1539-1558
19 Patsopoulos NA, Evangelou E, Ioannidis JP. Sensitivity of between-study heterogeneity in meta-analysis: proposed metrics and empirical evaluation. Int J Epidemiol 2008; 37: 1148-1157
20 Egger M, Davey Smith G, Schneider M. et al. Bias in meta-analysis detected by a simple, graphical test. BMJ 1997; 315: 629-634
21 Bello-Chavolla OY, Antonio-Villa NE, Vargas-Vazquez A. et al. Prediction of incident hypertension and arterial stiffness using the non-insulin-based metabolic score for insulin resistance (METS-IR) index. J Clin Hypertens (Greenwich) 2019; 21: 1063-1070
22 Liu XZ, Fan J, Pan SJ. METS-IR, a novel simple insulin resistance indexes, is associated with hypertension in normal-weight Chinese adults. J Clin Hypertens (Greenwich) 2019; 21: 1075-1081
23 Li Y, You A, Tomlinson B. et al. Insulin resistance surrogates predict hypertension plus hyperuricemia. J Diabetes Investig 2021; 12: 2046-2053
24 Cheng W, Kong F, Chen S. Comparison of the predictive value of four insulin resistance surrogates for the prevalence of hypertension: a population-based study. Diabetol Metab Syndr 2022; 14: 137
25 Gu Q, Meng J, Hu X. et al. Isolated systolic hypertension and insulin resistance assessment tools in young and middle-aged Chinese men with normal fasting glucose: a cross-sectional study. Sci Rep 2022; 12: 758
26 Han KY, Gu J, Wang Z. et al. Association between METS-IR and prehypertension or hypertension among normoglycemia subjects in Japan: a retrospective study. Front Endocrinol (Lausanne) 2022; 13: 851338
27 Mao Y, Ma R, Li Y. et al. Association of three insulin resistance indices with hypertension and body weight among Uyghur adults in rural areas of Xinjiang, China. J Clin Hypertens (Greenwich) 2022; 24: 1498-1505
28 Xu C, Song G, Hu D. et al. Association of METS-IR with incident hypertension in non-overweight adults based on a cohort study in Northeastern China. Eur J Public Health 2022; 32: 884-890
29 Bog-Hansen E, Lindblad U, Gullberg B. et al. Metabolic disorders associated with uncontrolled hypertension. Diabetes Obes Metab 2003; 5: 379-387
30 Zhu Z, Wang P, Ma S. Metabolic hypertension: concept and practice. Front Med 2013; 7: 201-206
31 da Silva AA, do Carmo JM, Li X. et al. Role of hyperinsulinemia and insulin resistance in hypertension: metabolic syndrome revisited. Can J Cardiol 2020; 36: 671-682
32 Mancusi C, Izzo R, di Gioia G. et al. Insulin resistance the hinge between hypertension and type 2 diabetes. High Blood Press Cardiovasc Prev 2020; 27: 515-526