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Open Access 01-12-2024 | Insulins | Research

Non-linear associations of HOMA2-IR with all-cause mortality in general populations: insights from NHANES 1999–2006

Authors: Aikai Zhang, Lingchen Huang, Min Tang

Published in: BMC Public Health | Issue 1/2024

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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Title: Non-linear associations of HOMA2-IR with all-cause mortality in general populations: insights from NHANES 1999–2006
Authors: Aikai Zhang
Lingchen Huang
Min Tang
Publication date: 01-12-2024
Publisher: BioMed Central
Keywords: Insulins
Insulins
Obesity
Obesity
Published in: BMC Public Health / Issue 1/2024
Electronic ISSN: 1471-2458
DOI: https://doi.org/10.1186/s12889-024-18026-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Non-linear associations of HOMA2-IR with all-cause mortality in general populations: insights from NHANES 1999–2006

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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