Metabolic Score for Insulin Resistance, a novel score to evaluate insulin sensitivity, is associated with the urinary albumin‐to‐creatinine ratio in Chinese adults: A cross‐sectional REACTION study

AIMS/INTRODUCTION: The Metabolic Score for Insulin Resistance (METS‐IR) is a novel non‐insulin‐based metabolic index used as a substitution marker of insulin resistance. However, whether METS‐IR is associated with the urinary albumin‐to‐creatinine ratio (UACR) is not well known. Therefore, we explored the associations between METS‐IR and UACR, and compared the discriminative ability of METS‐IR and its components for elevated UACR. MATERIALS AND METHODS: This study included 37,290 participants. METS‐IR was calculated as follows: (Ln[2 × fasting blood glucose + fasting triglyceride level] × body mass index) / (Ln [high‐density lipoprotein cholesterol]). Participants were divided into four groups on the basis of METS‐IR: <25%, 25–49%, 50–74% and ≥75%. Logistic regression analyses were carried out to determine the associations between METS‐IR versus its components (fasting blood glucose, triglyceride level, body mass index and high‐density lipoprotein cholesterol) with UACR. RESULTS: Participants with the highest quartile METS‐IR presented a more significant trend toward elevated UACR than toward its components (odds ratio 1.260, 95% confidence interval 1.152–1.378, P < 0.001 in all participants; odds ratio 1.321, 95% confidence interval 1.104–1.579, P = 0.002 in men; odds ratio 1.201, 95% confidence interval 1.083–1.330, P < 0.001 in women). There were significant associations between METS‐IR and UACR in younger participants (aged <65 years for women and aged 55–64 years for men). Increased METS‐IR was significantly associated with UACR in men with fasting blood glucose ≥5.6 or postprandial blood glucose ≥7.8 mmol/L and systolic blood pressure ≥120 or diastolic blood pressure ≥80 mmHg. The relationships were significant in women with diabetes and hypertension. CONCLUSIONS: Increased METS‐IR was significantly associated with elevated UACR, its discriminative power for elevated UACR was superior to that of its components.