Background

Insulin resistance (IR), the most important pathogenesis for type 2 diabetes mellitus (T2DM) and metabolic syndrome, has been demonstrated to be closely related to the occurrence, progression, and prognosis of atherosclerotic cardiovascular disease (ASCVD), regardless of the presence of diabetes mellitus [1,2,3,4,5,6]. Therefore, there is undisputedly a demand for precise and prompt quantification of IR, with the aim of early identification of patients at high risk of ASCVD, assessment of disease progression, and risk stratification for adverse outcomes.

The hyperinsulinaemic-euglycaemic (HIEG) clamp, which is the gold standard technique for the evaluation of IR, has been demonstrated to be closely associated with ASCVD by previous studies [7, 8]. However, the defects of operational complexity, time consumption, and expensiveness confined it from extensive clinical application. It has been revealed that IR usually manifests as hyperglycemia, hyperinsulinemia, dyslipidemia, and central obesity (especially increased visceral fat) [6, 9]. Based on the characteristics mentioned above, various surrogate markers calculated from common laboratory and anthropometric parameters, for example, triglyceride-glucose index (TyG index), visceral adiposity index (VAI), Chinese visceral adiposity index (CVAI), lipid accumulation product (LAP), and triglyceride-to-high density lipoprotein cholesterol ratio (TG/HDL-C), have been established to alternatively evaluate the extent of IR and shown to be closely correlated with HIEG clamp [10,11,20,

Availability of data and materials

The datasets used and/or analyzed during the present study are available from the corresponding author on reasonable request.

Abbreviations

IR:

Insulin resistance

T2DM:

Type 2 diabetes mellitus

ASCVD:

Atherosclerotic cardiovascular disease

HIEG:

Hyperinsulinaemic-euglycaemic

TyG:

Triglyceride-glucose

VAI:

Visceral adiposity index

CVAI:

Chinese visceral adiposity index

LAP:

Lipid accumulation product

TG/HDL-C:

Triglyceride-to-high density lipoprotein cholesterol ratio

PCI:

Percutaneous coronary intervention

NSTE-ACS:

Non-ST-segment elevation acute coronary syndrome

NSTEMI:

Non-ST-segment elevation myocardial infarction

UA:

Unstable angina

BMI:

Body mass index

WC:

Waist circumference

CAD:

Coronary artery disease

MI:

Myocardial infarction

PAD:

Peripheral artery disease

TG:

Triglyceride

TC:

Total cholesterol

LDL-C:

Low-density lipoprotein cholesterol

HDL-C:

High-density lipoprotein cholesterol

hs-CRP:

High-sensitivity C-reactive protein

eGFR:

Estimated glomerular filtration rate

FBG:

Fasting blood glucose

HbA1c:

Glycosylated hemoglobin A1c

LVEF:

Left ventricular ejection fraction

ACEI:

Angiotensin-converting enzyme inhibitor

ARB:

Angiotensin receptor blocker

SYNTAX:

The synergy between PCI with taxus and cardiac surgery

MACCE:

Major cardiovascular and cerebrovascular events

LM:

Left main artery

HR:

Hazard ratio

CI:

Confidence interval

ROC:

Receiver operating characteristics

AUC:

Area under the ROC curve

NRI:

Net reclassification improvement

IDI:

Integrated discrimination improvement

HOMA-IR:

Homeostasis model assessment of insulin resistance

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Acknowledgements

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Funding

This work was supported by the grant from National Key Research and Development Program of China (2017YFC0908800); Bei**g Municipal Administration of Hospitals “Mission plan” (SML20180601); Capital’s Funds for Health Improvement and Research (CFH2020-2-2063); KM200910025012; Bei**g Municipal Natural Science Foundation (7202041).

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Authors and Affiliations

  1. Department of Cardiology, Bei**g Anzhen Hospital, Capital Medical University, Bei**g Institute of Heart Lung and Blood Vessel Disease, Bei**g Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical Center for Coronary Heart Disease, Capital Medical University, Bei**g, 100029, China

    Qi Zhao, Yu-**g Cheng, Ying-Kai Xu, Zi-Wei Zhao, Chi Liu, Tie-Nan Sun & Yu-Jie Zhou

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  1. Qi Zhao
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Contributions

QZ made substantial contributions to study design, data analysis, and manuscript writing. Y-JZ made substantial contributions to study design, intellectual direction, and manuscript revision. Y-JC, Y-KX, Z-WZ, CL, and T-NS made substantial contributions to data collection and follow-up. All authors read and approved the final manuscript.

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Correspondence to Yu-Jie Zhou.

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The study protocol was endorsed by the Clinical Research Ethics Committee of Bei**g Anzhen Hospital, Capital Medical University. All subjects were informed and agreed to participate in the present study.

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Zhao, Q., Cheng, YJ., Xu, YK. et al. Comparison of various insulin resistance surrogates on prognostic prediction and stratification following percutaneous coronary intervention in patients with and without type 2 diabetes mellitus. Cardiovasc Diabetol 20, 190 (2021). https://doi.org/10.1186/s12933-021-01383-7

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