The Metabolic Score for Insulin Resistance (METS-IR) as a Predictor of Incident diabetes: A Longitudinal Study among Chinese without Diabetes

Background: As the prevalence of diabetes rises and the disease burden increases, it will be extremely beneficial to identify high-risk groups who are susceptible to diabetes early on using simple and effective diagnostic tools. Recently, it was discovered that T2DM is strongly correlated with METS-IR. However, it is unclear whether the relationship between T2DM and METS-IR is affected by time progression. Methods This study included 114,827 subjects (62186 men and 52641 women) who underwent a physical examination with a 7-years follow-up. The subjects were divided into five equal groups based on their METS-IR quintile, with the outcome of interest being the occurrence of diabetic events. Results Multivariate Cox proportional hazards regression analysis for the prediction of diabetes according to the METS-IR shows that METS-IR was strongly positively correlated with the risk of future diabetes (HR 1.11 per SD increase, 95% CI: 1.10-1.11), and the risk of diabetes corresponding to METS-IR was gradually increased compared with the lowest quintile group (P for trend < 0.001). ROC curve analysis demonstrated that METS-IR in females outperformed the prediction for T2DM compared to that in males. Among people with different phenotypes, it can be observed that younger individuals had a significantly higher risk of METS-IR-related diabetes than middle-aged and older individuals. Conclusions In summary, the present study demonstrated that METS-IR is an important independent predictor of new-onset diabetes in the Chinese general population, independent of traditional diabetes risk factors, especially in younger individuals.