Non-linear associations of HOMA2-IR with all-cause mortality in general populations: insights from NHANES 1999–2006
Abstract Background The association between homeostatic model assessment (HOMA2-IR) and mortality in obese and non-obese populations has not been clearly explained. Methods A total of 7,085 individuals aged ≥ 20 years from the 1999–2006 National Health and Nutrition Examination Survey were included...
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BMC
2024-02-01
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| Online Access: | https://doi.org/10.1186/s12889-024-18026-7 |
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| author | Aikai Zhang Lingchen Huang Min Tang |
| author_facet | Aikai Zhang Lingchen Huang Min Tang |
| author_sort | Aikai Zhang |
| collection | DOAJ |
| description | Abstract Background The association between homeostatic model assessment (HOMA2-IR) and mortality in obese and non-obese populations has not been clearly explained. Methods A total of 7,085 individuals aged ≥ 20 years from the 1999–2006 National Health and Nutrition Examination Survey were included in the study. Study endpoints were all-cause and cardiovascular mortality. Multivariate Cox proportional hazards regression models with restricted cubic spline analysis were used for analysis. Results In the study populations, a total of 1666 all-cause deaths and 555 cardiovascular (CV) deaths were recorded during a mean follow-up of 195.53 months. Notably, a significant difference in obesity was observed in the association between HOMA2-IR and mortality. After adjustment for multiple variables, HOMA2-IR was positively associated with all-cause mortality in all participants, in those with normal BMI, and in those with obesity. Conversely, tertile 2 of HOMA2-IR was associated with a lower risk of all-cause mortality in participants with obesity compared with tertile 1 (adjusted hazard ratio, 0.68; 95% confidence interval, 0.52–0.89; P = 0.005). Results from restricted cubic spline analysis showed a J-shaped association between HOMA2-IR and all-cause and CV mortality. In addition, a nonlinear U-shaped correlation with all-cause (P for nonlinear < 0.001) and CV (P for nonlinear = 0.002) mortality was observed in the population with obesity, with inflection points of HOMA2-IR identified at 1.85 and 1.75. Below the inflection point of 1.85, a negative relationship between HOMA2-IR and all-cause mortality was observed. Conclusions Elevated HOMA2-IR showed a notable correlation with increased risk of all-cause mortality. It was noteworthy that excessively reduced levels of insulin resistance showed a distinct association with increased mortality in individuals with obesity. |
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| language | English |
| last_indexed | 2024-03-07T14:37:12Z |
| publishDate | 2024-02-01 |
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| spelling | doaj.art-be907a7a18134bc79f0078b2e9733a9c2024-03-05T20:35:42ZengBMCBMC Public Health1471-24582024-02-012411910.1186/s12889-024-18026-7Non-linear associations of HOMA2-IR with all-cause mortality in general populations: insights from NHANES 1999–2006Aikai Zhang0Lingchen Huang1Min Tang2Department of Cardiology, State Key Laboratory of Cardiovascular Disease, Cardiovascular Institute, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical CollegeDepartment of Cardiac Surgery, State Key Laboratory of Cardiovascular Disease, Cardiovascular Institute, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical CollegeDepartment of Cardiology, State Key Laboratory of Cardiovascular Disease, Cardiovascular Institute, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical CollegeAbstract Background The association between homeostatic model assessment (HOMA2-IR) and mortality in obese and non-obese populations has not been clearly explained. Methods A total of 7,085 individuals aged ≥ 20 years from the 1999–2006 National Health and Nutrition Examination Survey were included in the study. Study endpoints were all-cause and cardiovascular mortality. Multivariate Cox proportional hazards regression models with restricted cubic spline analysis were used for analysis. Results In the study populations, a total of 1666 all-cause deaths and 555 cardiovascular (CV) deaths were recorded during a mean follow-up of 195.53 months. Notably, a significant difference in obesity was observed in the association between HOMA2-IR and mortality. After adjustment for multiple variables, HOMA2-IR was positively associated with all-cause mortality in all participants, in those with normal BMI, and in those with obesity. Conversely, tertile 2 of HOMA2-IR was associated with a lower risk of all-cause mortality in participants with obesity compared with tertile 1 (adjusted hazard ratio, 0.68; 95% confidence interval, 0.52–0.89; P = 0.005). Results from restricted cubic spline analysis showed a J-shaped association between HOMA2-IR and all-cause and CV mortality. In addition, a nonlinear U-shaped correlation with all-cause (P for nonlinear < 0.001) and CV (P for nonlinear = 0.002) mortality was observed in the population with obesity, with inflection points of HOMA2-IR identified at 1.85 and 1.75. Below the inflection point of 1.85, a negative relationship between HOMA2-IR and all-cause mortality was observed. Conclusions Elevated HOMA2-IR showed a notable correlation with increased risk of all-cause mortality. It was noteworthy that excessively reduced levels of insulin resistance showed a distinct association with increased mortality in individuals with obesity.https://doi.org/10.1186/s12889-024-18026-7Homeostatic model assessmentInsulin resistanceObesityNHANES |
| spellingShingle | Aikai Zhang Lingchen Huang Min Tang Non-linear associations of HOMA2-IR with all-cause mortality in general populations: insights from NHANES 1999–2006 BMC Public Health Homeostatic model assessment Insulin resistance Obesity NHANES |
| title | Non-linear associations of HOMA2-IR with all-cause mortality in general populations: insights from NHANES 1999–2006 |
| title_full | Non-linear associations of HOMA2-IR with all-cause mortality in general populations: insights from NHANES 1999–2006 |
| title_fullStr | Non-linear associations of HOMA2-IR with all-cause mortality in general populations: insights from NHANES 1999–2006 |
| title_full_unstemmed | Non-linear associations of HOMA2-IR with all-cause mortality in general populations: insights from NHANES 1999–2006 |
| title_short | Non-linear associations of HOMA2-IR with all-cause mortality in general populations: insights from NHANES 1999–2006 |
| title_sort | non linear associations of homa2 ir with all cause mortality in general populations insights from nhanes 1999 2006 |
| topic | Homeostatic model assessment Insulin resistance Obesity NHANES |
| url | https://doi.org/10.1186/s12889-024-18026-7 |
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