Association Between Different Insulin Resistance Indices and Heart Failure in US Adults With Diabetes Mellitus

ABSTRACT Purpose This study aims to scrutinize the association between various Insulin Resistance (IR) indices and heart failure (HF) risk in adult diabetics within the United States. Methods The National Health and Nutrition Examination Survey (NHANES) (2005–2018) dataset was used in this study. Weighted logistic regression analysis and restricted cubic spline were employed to ascertain the correlation between IR indices and the incidence of HF in diabetic patients. The predictive capability of the IR indices was evaluated using the Receiver Operating Characteristic curve. Results This study included a total of 2574 diabetic patients, out of which 209 (8.1%) were diagnosed with HF. After the adjustment of potential confounders, TyG‐BMI (OR: 1.005, 95% CI: 1.002–1.009), TG/HDL‐C (OR: 1.138, 95% CI: 1.024–1.265), and METS‐IR index (OR: 1.035, 95% CI: 1.015–1.057) were significantly associated with HF risk. RCS curves revealed nonlinear dose–response relationship between TyG, TyG‐BMI, TG/HDL‐C, and the occurrence of HF in diabetic patients. Subgroup analyses showed that four IR indices were positively associated with the risk of HF in the elderly diabetic population. Unfortunately, all IR indices failed to improve the predictive performance of the underlying risk model for HF in diabetic patients. Conclusion Four IR markers may be important predictors of HF risk in diabetics. Our main objective was to investigate the relationship between different insulin resistance indices and the risk of heart failure in US adults with diabetes, with a view to identifying patients at high risk of heart failure in the diabetic population at an early stage of the disease and intervening early to reduce the incidence of heart failure and improve patient prognosis. In conclusion, we found a U‐shaped dose–response relationship between TyG, TyG‐BMI, TG/HDL‐C, and heart failure risk in diabetic patients, whereas METS‐IR was linearly correlated. This study has potential implications for secondary prevention and stratification of heart failure risk in diabetic patients.