The metabolic score for insulin resistance index is associated with myocardial ischemia, with non-alcoholic fatty liver disease serving as an important bridge

BackgroundThis study aimed to evaluate the correlation between the metabolic score for insulin resistance (METS-IR) and myocardial ischemia based on myocardial perfusion imaging (MPI) and further examine whether non-alcoholic fatty liver disease (NAFLD) has a potential role in mediating these associ...

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Main Authors: Yu Tian, Fan Sun, Wenji Yu, Feifei Zhang, Jianfeng Wang, Xiaoliang Shao, Bao Liu, Xiaoyu Yang, Yongjun Chen, Sijin Li, Yuetao Wang
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-06-01
Series:Frontiers in Endocrinology
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Online Access:https://www.frontiersin.org/articles/10.3389/fendo.2025.1592463/full
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author Yu Tian
Yu Tian
Fan Sun
Fan Sun
Wenji Yu
Wenji Yu
Feifei Zhang
Feifei Zhang
Jianfeng Wang
Jianfeng Wang
Xiaoliang Shao
Xiaoliang Shao
Bao Liu
Bao Liu
Xiaoyu Yang
Yongjun Chen
Sijin Li
Yuetao Wang
Yuetao Wang
author_facet Yu Tian
Yu Tian
Fan Sun
Fan Sun
Wenji Yu
Wenji Yu
Feifei Zhang
Feifei Zhang
Jianfeng Wang
Jianfeng Wang
Xiaoliang Shao
Xiaoliang Shao
Bao Liu
Bao Liu
Xiaoyu Yang
Yongjun Chen
Sijin Li
Yuetao Wang
Yuetao Wang
author_sort Yu Tian
collection DOAJ
description BackgroundThis study aimed to evaluate the correlation between the metabolic score for insulin resistance (METS-IR) and myocardial ischemia based on myocardial perfusion imaging (MPI) and further examine whether non-alcoholic fatty liver disease (NAFLD) has a potential role in mediating these associations.MethodsThis retrospective study enrolled 1,242 patients with suspected coronary artery disease (CAD) who underwent single-photon emission computed tomography myocardial perfusion imaging (SPECT-MPI) at the Third Affiliated Hospital of Soochow University from 1 January 2022 to 31 December 2024. The association between METS-IR and myocardial ischemia was analyzed using the logistic regression model. The mediating effect of NAFLD was evaluated through mediation analysis to explore the potential mechanism underlying the association between METS-IR and myocardial ischemia.ResultsThe final group of participants included 335 patients; 179 (53.4%) patients had myocardial ischemia. Overall, the mean age was 61.45 ± 10.20 years, 188 (56.1%) were men, and the mean body mass index was 24.69 ± 3.21 kg/m2. Mean METS-IR was 2.40 ± 0.22 (range, 1.79–3.80). The results of the single-factor analysis showed that a per-SD increase in METS-IR was independently associated with myocardial ischemia (OR, 3.92; 95% CI: 1.38-11.08; P =0.010). After adjusting for all interfering factors, METS-IR had no associations with myocardial ischemia. The results of the mediation analysis show that NAFLD is a complete mediator variable between MERSIR and myocardial ischemia.ConclusionThis study provides evidence for the relationship between METS-IR and myocardial ischemia and highlights the important mediating role of NAFLD in this relationship.
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spelling doaj-art-967d30eb8e4641d2b871b00b11f9829e2025-08-20T02:03:16ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922025-06-011610.3389/fendo.2025.15924631592463The metabolic score for insulin resistance index is associated with myocardial ischemia, with non-alcoholic fatty liver disease serving as an important bridgeYu Tian0Yu Tian1Fan Sun2Fan Sun3Wenji Yu4Wenji Yu5Feifei Zhang6Feifei Zhang7Jianfeng Wang8Jianfeng Wang9Xiaoliang Shao10Xiaoliang Shao11Bao Liu12Bao Liu13Xiaoyu Yang14Yongjun Chen15Sijin Li16Yuetao Wang17Yuetao Wang18Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu, ChinaInstitute of Clinical Translation of Nuclear Medicine and Molecular Imaging, Soochow University, Changzhou, Jiangsu, ChinaDepartment of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu, ChinaInstitute of Clinical Translation of Nuclear Medicine and Molecular Imaging, Soochow University, Changzhou, Jiangsu, ChinaDepartment of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu, ChinaInstitute of Clinical Translation of Nuclear Medicine and Molecular Imaging, Soochow University, Changzhou, Jiangsu, ChinaDepartment of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu, ChinaInstitute of Clinical Translation of Nuclear Medicine and Molecular Imaging, Soochow University, Changzhou, Jiangsu, ChinaDepartment of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu, ChinaInstitute of Clinical Translation of Nuclear Medicine and Molecular Imaging, Soochow University, Changzhou, Jiangsu, ChinaDepartment of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu, ChinaInstitute of Clinical Translation of Nuclear Medicine and Molecular Imaging, Soochow University, Changzhou, Jiangsu, ChinaDepartment of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu, ChinaInstitute of Clinical Translation of Nuclear Medicine and Molecular Imaging, Soochow University, Changzhou, Jiangsu, ChinaDepartment of Cardiology, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu, ChinaDepartment of Cardiology, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu, ChinaDepartment of Nuclear Medicine, First Hospital of Shanxi Medical University, Taiyuan, Shanxi, ChinaDepartment of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu, ChinaInstitute of Clinical Translation of Nuclear Medicine and Molecular Imaging, Soochow University, Changzhou, Jiangsu, ChinaBackgroundThis study aimed to evaluate the correlation between the metabolic score for insulin resistance (METS-IR) and myocardial ischemia based on myocardial perfusion imaging (MPI) and further examine whether non-alcoholic fatty liver disease (NAFLD) has a potential role in mediating these associations.MethodsThis retrospective study enrolled 1,242 patients with suspected coronary artery disease (CAD) who underwent single-photon emission computed tomography myocardial perfusion imaging (SPECT-MPI) at the Third Affiliated Hospital of Soochow University from 1 January 2022 to 31 December 2024. The association between METS-IR and myocardial ischemia was analyzed using the logistic regression model. The mediating effect of NAFLD was evaluated through mediation analysis to explore the potential mechanism underlying the association between METS-IR and myocardial ischemia.ResultsThe final group of participants included 335 patients; 179 (53.4%) patients had myocardial ischemia. Overall, the mean age was 61.45 ± 10.20 years, 188 (56.1%) were men, and the mean body mass index was 24.69 ± 3.21 kg/m2. Mean METS-IR was 2.40 ± 0.22 (range, 1.79–3.80). The results of the single-factor analysis showed that a per-SD increase in METS-IR was independently associated with myocardial ischemia (OR, 3.92; 95% CI: 1.38-11.08; P =0.010). After adjusting for all interfering factors, METS-IR had no associations with myocardial ischemia. The results of the mediation analysis show that NAFLD is a complete mediator variable between MERSIR and myocardial ischemia.ConclusionThis study provides evidence for the relationship between METS-IR and myocardial ischemia and highlights the important mediating role of NAFLD in this relationship.https://www.frontiersin.org/articles/10.3389/fendo.2025.1592463/fullmetabolic score for insulin resistance (METS-IR)non-alcoholic fatty liver disease (NAFLD)myocardial ischemiamediating effectmyocardial perfusion imaging (MPI)
spellingShingle Yu Tian
Yu Tian
Fan Sun
Fan Sun
Wenji Yu
Wenji Yu
Feifei Zhang
Feifei Zhang
Jianfeng Wang
Jianfeng Wang
Xiaoliang Shao
Xiaoliang Shao
Bao Liu
Bao Liu
Xiaoyu Yang
Yongjun Chen
Sijin Li
Yuetao Wang
Yuetao Wang
The metabolic score for insulin resistance index is associated with myocardial ischemia, with non-alcoholic fatty liver disease serving as an important bridge
Frontiers in Endocrinology
metabolic score for insulin resistance (METS-IR)
non-alcoholic fatty liver disease (NAFLD)
myocardial ischemia
mediating effect
myocardial perfusion imaging (MPI)
title The metabolic score for insulin resistance index is associated with myocardial ischemia, with non-alcoholic fatty liver disease serving as an important bridge
title_full The metabolic score for insulin resistance index is associated with myocardial ischemia, with non-alcoholic fatty liver disease serving as an important bridge
title_fullStr The metabolic score for insulin resistance index is associated with myocardial ischemia, with non-alcoholic fatty liver disease serving as an important bridge
title_full_unstemmed The metabolic score for insulin resistance index is associated with myocardial ischemia, with non-alcoholic fatty liver disease serving as an important bridge
title_short The metabolic score for insulin resistance index is associated with myocardial ischemia, with non-alcoholic fatty liver disease serving as an important bridge
title_sort metabolic score for insulin resistance index is associated with myocardial ischemia with non alcoholic fatty liver disease serving as an important bridge
topic metabolic score for insulin resistance (METS-IR)
non-alcoholic fatty liver disease (NAFLD)
myocardial ischemia
mediating effect
myocardial perfusion imaging (MPI)
url https://www.frontiersin.org/articles/10.3389/fendo.2025.1592463/full
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