The metabolic score for insulin resistance (METS-IR), a predictor of cardiovascular events, relates to disease activity in patients with rheumatoid arthritis

Background: The Metabolic Score for Insulin Resistance (METS-IR) is a newly developed index that has been described to predict cardiovascular (CV) events. In this study, we calculated the METS-IR index in patients with rheumatoid arthritis (RA), a condition linked to an elevated CV risk. We then exa...

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Autores: Aznar-Esquivel, Antonio, Gómez-Bernal, Fuensanta, García-González, María, Hernández-Díaz, Marta, Heras-Recuero, Elena, Vera-González, Antonia de, Gónzalez-Delgado, Alejandra, Quevedo-Rodríguez, Adrián, Quevedo-Abeledo, Juan C., Castañeda, Santos, González-Gay Mantecón, Miguel Ángel, Ferraz-Amaro, Iván
Tipo de recurso: artículo
Fecha de publicación:2025
País:España
Institución:Universidad de Cantabria (UC)
Repositorio:UCrea Repositorio Abierto de la Universidad de Cantabria
Idioma:inglés
OAI Identifier:oai:repositorio.unican.es:10902/36844
Acceso en línea:https://hdl.handle.net/10902/36844
Access Level:acceso abierto
Palabra clave:Rheumatoid arthritis
METS-IR index
Cardiovascular risk
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spelling The metabolic score for insulin resistance (METS-IR), a predictor of cardiovascular events, relates to disease activity in patients with rheumatoid arthritisAznar-Esquivel, AntonioGómez-Bernal, FuensantaGarcía-González, MaríaHernández-Díaz, MartaHeras-Recuero, ElenaVera-González, Antonia deGónzalez-Delgado, AlejandraQuevedo-Rodríguez, AdriánQuevedo-Abeledo, Juan C.Castañeda, SantosGonzález-Gay Mantecón, Miguel ÁngelFerraz-Amaro, IvánRheumatoid arthritisMETS-IR indexCardiovascular riskBackground: The Metabolic Score for Insulin Resistance (METS-IR) is a newly developed index that has been described to predict cardiovascular (CV) events. In this study, we calculated the METS-IR index in patients with rheumatoid arthritis (RA), a condition linked to an elevated CV risk. We then examined its relationship with disease characteristics and CV comorbidities, including disease activity, lipid profile, subclinical carotid atherosclerosis, and insulin resistance indices. Methods: A total of 515 RA patients were recruited. Disease-related characteristics and disease activity indices, including the Disease Activity Score (DAS28), the Clinical Disease Activity Index (CDAI), and the Simple Disease Activity Index (SDAI) were calculated. Additionally, the complete lipid profile, insulin resistance indices, metabolic syndrome criteria, and carotid ultrasound for intima-media thickness and carotid plaque detection were assessed. METS-IR was calculated. A multivariable linear regression analysis was performed to examine the associations between the disease characteristics and METS-IR. Results: METS-IR was positively correlated with age, body mass index, and traditional cardiovascular risk factors such as metabolic syndrome and insulin resistance indices. Carotid intima-media thickness-but not the presence of carotid plaque-was associated with significantly higher METS-IR values. Regarding disease-related characteristics, C-reactive protein and disease activity indices demonstrated a significant positive association with METS-IR after multivariable adjustment. Specifically, C-reactive protein was associated with higher METS-IR values (beta coefficient 0.2, 95% CI: 0.1-0.3, p < 0.001). All disease activity indices, except CDAI, showed a significant positive relationship with METS-IR. Conclusions: METS-IR is linked not only to CV risk factors but also, independently, to inflammatory disease activity in patients with RA. Its association with CV events in the general population and disease activity in RA highlights the significant role of inflammation in driving excessive cardiovascular risk in RA. This underscores the intricate relationship between metabolic dysfunction, systemic inflammation, and CV outcomes in RA.This study was funded by a grant to IF-A by Instituto de Salud Carlos III (ISCIII) through project PI23/00046 and co-funded by the European Union. M.A. González-Gay’s research was supported by the Spanish Ministry of Health, Instituto de Salud Carlos III (ISCIII), Spanish Red de Investigación RICORS-RD24/0007/0031 and PI24/00554.MDPIUniversidad de Cantabria20252025-01-01journal articlehttp://purl.org/coar/resource_type/c_6501NAhttp://purl.org/coar/version/c_be7fb7dd8ff6fe43info:eu-repo/semantics/articlehttps://hdl.handle.net/10902/36844Diagnostics, 2025, 15, 861reponame:UCrea Repositorio Abierto de la Universidad de Cantabriainstname:Universidad de Cantabria (UC)Inglésengopen accesshttp://purl.org/coar/access_right/c_abf2Attribution 4.0 Internationalhttp://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:repositorio.unican.es:10902/368442026-06-02T12:39:31Z
dc.title.none.fl_str_mv The metabolic score for insulin resistance (METS-IR), a predictor of cardiovascular events, relates to disease activity in patients with rheumatoid arthritis
title The metabolic score for insulin resistance (METS-IR), a predictor of cardiovascular events, relates to disease activity in patients with rheumatoid arthritis
spellingShingle The metabolic score for insulin resistance (METS-IR), a predictor of cardiovascular events, relates to disease activity in patients with rheumatoid arthritis
Aznar-Esquivel, Antonio
Rheumatoid arthritis
METS-IR index
Cardiovascular risk
title_short The metabolic score for insulin resistance (METS-IR), a predictor of cardiovascular events, relates to disease activity in patients with rheumatoid arthritis
title_full The metabolic score for insulin resistance (METS-IR), a predictor of cardiovascular events, relates to disease activity in patients with rheumatoid arthritis
title_fullStr The metabolic score for insulin resistance (METS-IR), a predictor of cardiovascular events, relates to disease activity in patients with rheumatoid arthritis
title_full_unstemmed The metabolic score for insulin resistance (METS-IR), a predictor of cardiovascular events, relates to disease activity in patients with rheumatoid arthritis
title_sort The metabolic score for insulin resistance (METS-IR), a predictor of cardiovascular events, relates to disease activity in patients with rheumatoid arthritis
dc.creator.none.fl_str_mv Aznar-Esquivel, Antonio
Gómez-Bernal, Fuensanta
García-González, María
Hernández-Díaz, Marta
Heras-Recuero, Elena
Vera-González, Antonia de
Gónzalez-Delgado, Alejandra
Quevedo-Rodríguez, Adrián
Quevedo-Abeledo, Juan C.
Castañeda, Santos
González-Gay Mantecón, Miguel Ángel
Ferraz-Amaro, Iván
author Aznar-Esquivel, Antonio
author_facet Aznar-Esquivel, Antonio
Gómez-Bernal, Fuensanta
García-González, María
Hernández-Díaz, Marta
Heras-Recuero, Elena
Vera-González, Antonia de
Gónzalez-Delgado, Alejandra
Quevedo-Rodríguez, Adrián
Quevedo-Abeledo, Juan C.
Castañeda, Santos
González-Gay Mantecón, Miguel Ángel
Ferraz-Amaro, Iván
author_role author
author2 Gómez-Bernal, Fuensanta
García-González, María
Hernández-Díaz, Marta
Heras-Recuero, Elena
Vera-González, Antonia de
Gónzalez-Delgado, Alejandra
Quevedo-Rodríguez, Adrián
Quevedo-Abeledo, Juan C.
Castañeda, Santos
González-Gay Mantecón, Miguel Ángel
Ferraz-Amaro, Iván
author2_role author
author
author
author
author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv Universidad de Cantabria
dc.subject.none.fl_str_mv Rheumatoid arthritis
METS-IR index
Cardiovascular risk
topic Rheumatoid arthritis
METS-IR index
Cardiovascular risk
description Background: The Metabolic Score for Insulin Resistance (METS-IR) is a newly developed index that has been described to predict cardiovascular (CV) events. In this study, we calculated the METS-IR index in patients with rheumatoid arthritis (RA), a condition linked to an elevated CV risk. We then examined its relationship with disease characteristics and CV comorbidities, including disease activity, lipid profile, subclinical carotid atherosclerosis, and insulin resistance indices. Methods: A total of 515 RA patients were recruited. Disease-related characteristics and disease activity indices, including the Disease Activity Score (DAS28), the Clinical Disease Activity Index (CDAI), and the Simple Disease Activity Index (SDAI) were calculated. Additionally, the complete lipid profile, insulin resistance indices, metabolic syndrome criteria, and carotid ultrasound for intima-media thickness and carotid plaque detection were assessed. METS-IR was calculated. A multivariable linear regression analysis was performed to examine the associations between the disease characteristics and METS-IR. Results: METS-IR was positively correlated with age, body mass index, and traditional cardiovascular risk factors such as metabolic syndrome and insulin resistance indices. Carotid intima-media thickness-but not the presence of carotid plaque-was associated with significantly higher METS-IR values. Regarding disease-related characteristics, C-reactive protein and disease activity indices demonstrated a significant positive association with METS-IR after multivariable adjustment. Specifically, C-reactive protein was associated with higher METS-IR values (beta coefficient 0.2, 95% CI: 0.1-0.3, p < 0.001). All disease activity indices, except CDAI, showed a significant positive relationship with METS-IR. Conclusions: METS-IR is linked not only to CV risk factors but also, independently, to inflammatory disease activity in patients with RA. Its association with CV events in the general population and disease activity in RA highlights the significant role of inflammation in driving excessive cardiovascular risk in RA. This underscores the intricate relationship between metabolic dysfunction, systemic inflammation, and CV outcomes in RA.
publishDate 2025
dc.date.none.fl_str_mv 2025
2025-01-01
dc.type.none.fl_str_mv journal article
http://purl.org/coar/resource_type/c_6501
NA
http://purl.org/coar/version/c_be7fb7dd8ff6fe43
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv https://hdl.handle.net/10902/36844
url https://hdl.handle.net/10902/36844
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
Attribution 4.0 International
http://creativecommons.org/licenses/by/4.0/
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2
Attribution 4.0 International
http://creativecommons.org/licenses/by/4.0/
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv MDPI
publisher.none.fl_str_mv MDPI
dc.source.none.fl_str_mv Diagnostics, 2025, 15, 861
reponame:UCrea Repositorio Abierto de la Universidad de Cantabria
instname:Universidad de Cantabria (UC)
instname_str Universidad de Cantabria (UC)
reponame_str UCrea Repositorio Abierto de la Universidad de Cantabria
collection UCrea Repositorio Abierto de la Universidad de Cantabria
repository.name.fl_str_mv
repository.mail.fl_str_mv
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