Metabolic Score for Insulin Resistance (METS-IR) Associations with Subclinical Left Ventricular and Left Atrial Remodelling in Young Subjects with Hypertension

<jats:title>Abstract</jats:title> <jats:sec> <jats:title>Background:</jats:title> <jats:p>Insulin resistance (IR) is associated with left ventricular (LV) remodeling and eventually leads to cardiovascular events. Recently elaborated metabolic score for IR (METS-IR) is one of noninsulin-based scores for insulin sensitivity estimation. In previous studies, METS-IR was predictive for incident type 2 diabetes, hypertension, and arterial stiffness. Associations of METS-IR with subclinical myocardial damage were discussed in a few works.</jats:p> </jats:sec> <jats:sec> <jats:title>Objective:</jats:title> <jats:p>The objective of the study was to investigate relationship between IR estimated with METS-IR and early heart remodeling in young patients with hypertension.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods:</jats:title> <jats:p>We included 96 hypertensive subjects free of diabetes mellitus aged 18–45 years in prospective cross-sectional study. In each patient, we estimated IR with homeostasis model assessment-estimated IR (HOMA-IR) and METS-IR scores, performed ambulatory blood pressure monitoring and echocardiography including 2D speckle-tracking.</jats:p> </jats:sec> <jats:sec> <jats:title>Results:</jats:title> <jats:p>Patients with the highest METS-IR quartile had significantly higher left ventricular mass index (LVMI) and differed from patients with lower METS-IR score in some of the diastolic function characteristics but not in LV global longitudinal strain. METS-IR had stronger correlation with most of the echocardiographic features of abnormal LV geometry and function, including LVMI, relative wall thickness, e’, E/e’, tricuspid regurgitation velocity, left atrial (LA) volume index, and LV global longitudinal strain, than HOMA-IR. In multiple regression analysis METS-IR was independently associated with LVMI (<jats:italic toggle="yes">B</jats:italic> = 0.80 [0.37; 1.22], <jats:italic toggle="yes">P</jats:italic> < 0.0001) and LA reservoir stain (LARs) (<jats:italic toggle="yes">B</jats:italic> = −0.40 (−0.57; −0.23), <jats:italic toggle="yes">P</jats:italic> < 0.0001).</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusion:</jats:title> <jats:p>Noninsulin-based index of IR METS-IR is independently associated with LV and LA remodeling in young subjects with hypertension.</jats:p> </jats:sec>