AUTHOR=Zhang Qiuling , Wei Yushuang , Huang Shengzhu , Mo YeMei , Yan Boteng , Jin Xihui , Xu Mingjie , Mai Xiaoyou , Tang Chaoyan , Lan Haiyun , Liu Rongrong , Li Mingli , Mo Zengnan , Xie Wenchao 

TITLE=Association of metabolic score for insulin resistance with incident metabolic syndrome: a cohort study in middle-aged and older adult Chinese population

JOURNAL=Frontiers in Public Health

VOLUME=Volume 13 - 2025

YEAR=2025

URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2025.1453144

DOI=10.3389/fpubh.2025.1453144

ISSN=2296-2565

ABSTRACT=BackgroundRecent studies suggest that the metabolic score for insulin resistance (MetS-IR) is an effective indicator of metabolic disorders. However, evidence on the relationship between MetS-IR and metabolic syndrome (MetS) among the Chinese middle-aged and older adult population is limited.ObjectiveThis cohort study aims to assess the associations of MetS-IR levels with MetS risk and its components.MethodsData used in this study from the National Basic Public Health Service Project Management System (2020–2023). Multivariable Cox proportional hazards model and restricted cubic spline (RCS) were employed to evaluate the associations of baseline MetS-IR levels with MetS risk and its components, receiver operating characteristic (ROC) curves were further utilized to assess the efficacy of MetS-IR in predicting the risk of MetS and its component.ResultsOf 1,498 subjects without MetS at baseline, 392 incident MetS cases were observed during a median of 27.70 months of follow-up. The adjusted multivariable Cox regression analysis indicated an elevated 15% risk of developing MetS for 1-SD increment of MetS-IR [hazard ratios (HRs) and 95% confidence intervals: 1.16 (1.13–1.18)]. Compared to the first tertile of MetS-IR, the HRs of the third tertile and second tertile were 6.31 (95% CI 4.55–8.76) and 2.72 (95% CI 1.92–3.85), respectively. Consistent findings were further detected across subgroups. Moreover, nonlinear associations were observed between MetS-IR and the risk of MetS, abdominal obesity, and reduced high-density lipoprotein concentration (HDL-C) (Pnonlinear < 0.01), with the cutoff of MetS-IR was 32.89. The area under the curve for MetS-IR in predicting MetS was 0.740 (95% CI 0.713–0.768), which was better than those of other indicators.ConclusionOur cohort study indicates a positive nonlinear association between MetS-IR with incident MetS, abdominal obesity, and reduced HDL-C, but positive linear associations of MetS-IR and elevated blood pressure (BP), elevated fasting blood glucose (FBG), elevated triglycerides (TG) in middle-aged and older adult people, more studies are warranted to verify our findings.