Renal failure · 2026
Sex-specific association between metabolic score for insulin resistance and mortality in incident peritoneal dialysis patients.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод в очереди
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Tang Ruiying, Chen Jiexin, Zhan Xiaojiang, Peng Fenfen, Luo Xueyao, Tian Na, Wang Xiaoyang, Wen Yueqiang, Feng Xiaoran, Su Ning, Deng Jihong, Tang Xingming, Wu Xianfeng, Zhou Qian, Wu Juan, Xu Qingdong
Аннотация
BACKGROUND: The relationship between metabolic score for insulin resistance index (METS-IR) and all-cause and cardiovascular disease (CVD) mortality in peritoneal dialysis (PD) patients remains unexplored. Hence, we aimed to assess the association of METS-IR with mortality, specifically examining sex differences.
METHODS: In this multicenter cohort study, a total of 3,471 patients were enrolled between 01 January 2006 and 31 December 2017. Associations between METS-IR and all-cause and CVD mortality were examined using multivariate Cox regression analysis, with sex-based differences also assessed.
RESULTS: Participants had a mean age of 51.34 ± 14.61 years, 44.04% female. The mean MESTS-IR in Quartile 1, Quartile 2, Quartile 3, and Quartile 4 was 26.22 ± 2.18, 31.40 ± 1.21, 35.94 ± 1.42 and 44.07 ± 5.29 respectively. A comparison of Quartile 4 to Quartile 1 using the multivariate Cox regression analysis revealed significant increases in the hazard ratio (HR) for all-cause mortality (HR: 1.42, 95% confidence interval (CI): 1.02 to 1.97) and CVD mortality (HR: 1.78, 95% CI: 1.16 to 2.54) in the entire population. In female PD patients, the Quartile 4 was associated with an approximately 126% greater risk of all-cause mortality and 165% greater risk of CVD mortality compared with Quartile 1 in the multivariate analysis. However, the result showed no significance in men.
CONCLUSIONS: The METS-IR could serve as an effective prognostic indicator of mortality in women undergoing PD, indicating that early detection and intervention toward insulin resistance, represented by the METS-IR index, may offer clinical benefits for this identified group.
METHODS: In this multicenter cohort study, a total of 3,471 patients were enrolled between 01 January 2006 and 31 December 2017. Associations between METS-IR and all-cause and CVD mortality were examined using multivariate Cox regression analysis, with sex-based differences also assessed.
RESULTS: Participants had a mean age of 51.34 ± 14.61 years, 44.04% female. The mean MESTS-IR in Quartile 1, Quartile 2, Quartile 3, and Quartile 4 was 26.22 ± 2.18, 31.40 ± 1.21, 35.94 ± 1.42 and 44.07 ± 5.29 respectively. A comparison of Quartile 4 to Quartile 1 using the multivariate Cox regression analysis revealed significant increases in the hazard ratio (HR) for all-cause mortality (HR: 1.42, 95% confidence interval (CI): 1.02 to 1.97) and CVD mortality (HR: 1.78, 95% CI: 1.16 to 2.54) in the entire population. In female PD patients, the Quartile 4 was associated with an approximately 126% greater risk of all-cause mortality and 165% greater risk of CVD mortality compared with Quartile 1 in the multivariate analysis. However, the result showed no significance in men.
CONCLUSIONS: The METS-IR could serve as an effective prognostic indicator of mortality in women undergoing PD, indicating that early detection and intervention toward insulin resistance, represented by the METS-IR index, may offer clinical benefits for this identified group.