Association Analysis of Insulin Resistance Metabolic Score (METS-IR) and Gestational Diabetes Mellitus: Based on National Health and Nutrition Examination Survey Database From 2007 to 2018

Abstract

Objective

This study focused on the association of the Insulin resistance metabolic score (METS-IR) with the risk of gestational diabetes mellitus (GDM) using data from the National Health and Nutrition Examination Survey (NHANES).

Methods

Data from 6 cycles of NHANES (2007–2018) were analysed. Weighted logistic regression models were constructed to explore the relationship between METS-IR and GDM. Stratified and subgroup analyses with adjustment for confounding factors were carried out to explore the association between METS-IR and GDM.

Results

A total of 5189 samples were analysed. Based on the weighted logistic regression model, Ln(METS-IR) was positively associated with GDM with full adjustment (OR = 1.94, 95% CI 1.08–3.46, p < 0.005). After transferring Ln(METS-IR) into a categorical variable by quartiles, the positive connection between Ln(METS-IR) and GDM was still observed in the higher Ln(METS-IR) group compared to the lowest Ln(METS-IR) interval (OR of 1.86, 1.76 for participants in the Q3(3.73, 3.93) and Q4(3.93, 4.83) quartile, respectively, p < 0.05). The threshold effect model showed that when Ln(METS-IR) ≤ 4, the positive correlation between Ln(METS-IR) and GDM was more significant (β = 2.69, 95% CI 1.55–4.67, p = 0.0004). The area under the ROC curves of Ln(METS-IR) for GDM was 0.603, suggesting Ln(METS-IR) a more systematic predictor for GDM. Specifically, the OR and 95% CIs of GDM for women above high school in the Q2, Q3, and Q4 quartiles were 2.05 (1.04, 4.02), 3.41 (1.72, 6.78) and 2.78 (1.55, 4.99), respectively.

Conclusion

METS-IR in women elevates the likelihood of GDM occurrence. METS-IR serves as a comprehensive alternative to HOMA-IR rather than HbA1c and non-based insulin level to predict GDM.