PP mediated the relationship between METS-IR and AIS in non-diabetic patients

BackgroundThe correlation between metabolic score for insulin resistance (METS-IR) and high insulin normal glucose clamp test is stronger than other non-insulin-based insulin resistance scores. Insulin resistance was related to the occurrence and development of hypertension and stroke, however, the association between METS-IR and hypertension, as well as ischemic stroke is lack of evidence. This study aimed to determine the association between METS-IR and acute ischemic stroke in non-diabetic patients, and the mediating role of blood pressure parameters on it. MethodsThis hospital-based study included 557 non-diabetic subjects diagnosed with premature acute ischemic stroke. Logistic regression models and mediation analyses were conducted to assess the role of blood pressure parameters (systolic blood pressure, diastolic blood pressure, pulse pressure and mean arterial pressure) in the associations between METS-IR and risk of acute ischemic stroke. ResultsAfter adjusting for potential covariates, each SD increment of METS-IR was associated with 26% higher odds (OR = 1.26, 95% CI: 1.06-1.52) increment in ORs of acute ischemic stroke. The OR for acute ischemic stroke in patients with highest quartile of METS-IR was 1.73 hold (OR = 1.73, 95% CI: 1.12-2.70) higher than that in those with the lowest quartile of METS-IR. Furthermore, mediation analyses indicated that pulse pressure partially mediate the detrimental effect of insulin resistance (assessed by the METS-IR) on acute ischemic stroke (mediation percentage: 11.70%). ConclusionsOur study suggests a relationship between METS-IR and acute ischemic stroke, and the association of METS-IR with acute ischemic stroke was partially mediated by pulse pressure.