ORIGINAL RESEARCH article
Front. Endocrinol.
Sec. Cardiovascular Endocrinology
Volume 16 - 2025 | doi: 10.3389/fendo.2025.1592463
Metabolic score for insulin resistance index is associated with myocardial ischemia, nonalcoholic fatty liver disease serves as an important bridge
Provisionally accepted
Yu Tian1
Fan Sun1
Yu Wenji1
Feifei Zhang1
Jianfeng Wang1
Xiaoliang Shao1
Bao Liu1Xiaoyu Yang1Yongjun Chen1
Sijin Li2
Yuetao Wang1*- 1Third Affiliated Hospital of Soochow University, Changzhou, China
- 2First Hospital of Shanxi Medical University, Taiyuan, Shaanxi, China
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Background: To evaluate the correlation between the metabolic score for insulin resistance (METS-IR) and myocardial ischemia based on myocardial perfusion imaging (MPI) and further examine whether non-alcoholic fatty liver disease (NAFLD) has a potential role in mediating these associations.Methods: This retrospective study enrolled 1,242 patients with suspected coronary artery disease (CAD) who underwent single-photon emission computed tomography myocardial perfusion imaging (SPECT-MPI) at the Third Affiliated Hospital of Soochow University from January 1, 2022, to December 31, 2024. The association between METS-IR and myocardial ischemia was analyzed using the logistic regression model. The mediating effect of NAFLD was evaluated through mediation analysis to explore the potential mechanism underlying the association between METS-IR and myocardial ischemia.The final group of participants included 335 patients; 179 (53.4%) patients had myocardial ischemia. Overall, the mean age was 61.45±10.20 years, 188 (56.1%) were men, and mean BMI was 24.69±3.21 kg/ m 2 . Mean METS-IR was 2. 40±0.22 (range, 1.79-3.80). The results of the single-factor analysis showed that a per-SD increase in METS-IR was independently associated with myocardial ischemia (OR, 3.92; 95% CI: 1.38-11.08; P =0.010). After adjusting all interfering factors, METS-IR had no associations with myocardial ischemia. The results of the mediation analysis show that NAFLD is a complete mediator variable between MERSIR and myocardial ischemia.This study provides evidence for the relationship between METS-IR and myocardial ischemia, also highlights the important mediating role of NAFLD in this relationship.
Keywords: metabolic score for insulin resistance (METS-IR), Non-alcoholic fatty liver disease (NAFLD), Myocardial Ischemia, Mediating effect, Myocardial perfusion
Received: 12 Mar 2025; Accepted: 13 May 2025.
Copyright: © 2025 Tian, Sun, Wenji, Zhang, Wang, Shao, Liu, Yang, Chen, Li and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Yuetao Wang, Third Affiliated Hospital of Soochow University, Changzhou, China
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