Comparing the effectiveness of different indicators of insulin resistance in predicting diabetes among adults with sarcopenia from the NHANES (1999-2018).

The aim of this research is to investigate the correlation between indicators of various types of insulin resistance and the likelihood of developing diabetes in populations exhibiting sarcopenia. This cross-sectional study includes adults who participated in the National Health and Nutrition Examination Survey from 1999 to 2018. Insulin sensitivity indicators primarily include the IR metabolic score (METS-IR), triglyceride glucose index (TyG), triglyceride glucose index body mass index (TyG-BMI), triglyceride glucose index waist circumference (TyG-WC), and triglyceride to high-density lipoprotein cholesterol ratio for assessing insulin sensitivity. Muscle mass measurements are obtained using dual-energy x-ray absorptiometry. Employing various statistical techniques such as multiple logistic regression, analysis of receiver operating characteristic curves, subgroup analysis and interaction analysis will be conducted to assess the correlation between different indicators of insulin resistance and the likelihood of developing diabetes in populations affected by sarcopenia or those suspected to have sarcopenia. A total of 1632 adults aged over 18 were included in this study. It was observed that METS-IR, TyG index, TyG-BMI, TyG-WC, and triglyceride to high-density lipoprotein cholesterol were all positively associated with the risk of diabetes in populations with sarcopenia. The results remained consistent after adjusting for confounding factors. Receiver operating characteristic curve analysis demonstrated that TyG exhibited the most superior predictive efficacy for diabetes within this specific population cohort, particularly among males. Notably, a statistically significant distinction was observed in comparison to females (P < .05). The results of the subgroup analysis indicated that, across all examined subgroups, there was a positive correlation between the risk of diabetes and different indicators of insulin resistance in populations with sarcopenia. Our research findings suggest that METS-IR, TyG, TyG-BMI, TyG-WC, and TG/HDL are all positively associated with the incidence of diabetes in populations with sarcopenia. These biomarkers can be utilized for predicting the onset of diabetes in such populations. Among these biomarkers, TyG exhibits a higher predictive value for diabetes in this group, particularly among male individuals.