The non-linear relationship between the metabolic score for insulin resistance and three-month outcomes in the individuals with acute ischemic stroke: a prospective Korean cohort study

Abstract Background The metabolic score for insulin resistance (METS-IR) is considered a novel, non-invasive, and validated assessment of insulin resistance (IR), which may contribute to a poor neurological prognosis after stroke. However, evidence on the correlation between METS-IR and stroke progn...

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Main Authors: Yingkai Gao, Wenping Sun
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Neurology
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Online Access:https://doi.org/10.1186/s12883-025-04299-x
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author Yingkai Gao
Wenping Sun
author_facet Yingkai Gao
Wenping Sun
author_sort Yingkai Gao
collection DOAJ
description Abstract Background The metabolic score for insulin resistance (METS-IR) is considered a novel, non-invasive, and validated assessment of insulin resistance (IR), which may contribute to a poor neurological prognosis after stroke. However, evidence on the correlation between METS-IR and stroke prognosis in populations with acute ischemic stroke (AIS) remains limited. Therefore, this research aims to assess the effect of METS-IR levels on three-month unfavorable outcomes after AIS. Methods This prospective cohort study enrolled 1,722 AIS subjects who received treatment at a Korean hospital. The effect of METS-IR levels on three-month unfavorable outcomes was analyzed using a binary logistic regression model, while smoothed curve fitting and generalized additive modeling were applied to investigate non-linear associations. Results There was a non-linear correlation between METS-IR and three-month unfavorable outcomes after AIS was identified in this study. An inflection point in this relationship was observed at a METS-IR value of 35.16. For METS-IR values ≤ 35.16, a significant negative correlation was detected, with higher METS-IR levels being associated with a reduced risk of three-month unfavorable outcomes (OR: 0.93, 95% CI: 0.89–0.97, P = 0.0009). Conversely, for METS-IR values above this threshold, the association was no longer statistically significant (OR: 1.02, 95% CI: 0.99–1.05, P = 0.2486). Conclusion Our findings revealed a non-linear negative correlation between the effect of METS-IR levels on three-month unfavorable prognosis in AIS subjects.
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spelling doaj-art-331cbd6820f14c1a945bffac6584f6cd2025-08-20T03:45:32ZengBMCBMC Neurology1471-23772025-07-012511910.1186/s12883-025-04299-xThe non-linear relationship between the metabolic score for insulin resistance and three-month outcomes in the individuals with acute ischemic stroke: a prospective Korean cohort studyYingkai Gao0Wenping Sun1The First Hospital of Jilin UniversityDepartment of General Practice, Songjiang Hospital Affiliated to Shanghai Jiao Tong University School of MedicineAbstract Background The metabolic score for insulin resistance (METS-IR) is considered a novel, non-invasive, and validated assessment of insulin resistance (IR), which may contribute to a poor neurological prognosis after stroke. However, evidence on the correlation between METS-IR and stroke prognosis in populations with acute ischemic stroke (AIS) remains limited. Therefore, this research aims to assess the effect of METS-IR levels on three-month unfavorable outcomes after AIS. Methods This prospective cohort study enrolled 1,722 AIS subjects who received treatment at a Korean hospital. The effect of METS-IR levels on three-month unfavorable outcomes was analyzed using a binary logistic regression model, while smoothed curve fitting and generalized additive modeling were applied to investigate non-linear associations. Results There was a non-linear correlation between METS-IR and three-month unfavorable outcomes after AIS was identified in this study. An inflection point in this relationship was observed at a METS-IR value of 35.16. For METS-IR values ≤ 35.16, a significant negative correlation was detected, with higher METS-IR levels being associated with a reduced risk of three-month unfavorable outcomes (OR: 0.93, 95% CI: 0.89–0.97, P = 0.0009). Conversely, for METS-IR values above this threshold, the association was no longer statistically significant (OR: 1.02, 95% CI: 0.99–1.05, P = 0.2486). Conclusion Our findings revealed a non-linear negative correlation between the effect of METS-IR levels on three-month unfavorable prognosis in AIS subjects.https://doi.org/10.1186/s12883-025-04299-xMetabolic score for insulin resistanceAcute ischemic strokeUnfavorable outcomesNon-linear relationship
spellingShingle Yingkai Gao
Wenping Sun
The non-linear relationship between the metabolic score for insulin resistance and three-month outcomes in the individuals with acute ischemic stroke: a prospective Korean cohort study
BMC Neurology
Metabolic score for insulin resistance
Acute ischemic stroke
Unfavorable outcomes
Non-linear relationship
title The non-linear relationship between the metabolic score for insulin resistance and three-month outcomes in the individuals with acute ischemic stroke: a prospective Korean cohort study
title_full The non-linear relationship between the metabolic score for insulin resistance and three-month outcomes in the individuals with acute ischemic stroke: a prospective Korean cohort study
title_fullStr The non-linear relationship between the metabolic score for insulin resistance and three-month outcomes in the individuals with acute ischemic stroke: a prospective Korean cohort study
title_full_unstemmed The non-linear relationship between the metabolic score for insulin resistance and three-month outcomes in the individuals with acute ischemic stroke: a prospective Korean cohort study
title_short The non-linear relationship between the metabolic score for insulin resistance and three-month outcomes in the individuals with acute ischemic stroke: a prospective Korean cohort study
title_sort non linear relationship between the metabolic score for insulin resistance and three month outcomes in the individuals with acute ischemic stroke a prospective korean cohort study
topic Metabolic score for insulin resistance
Acute ischemic stroke
Unfavorable outcomes
Non-linear relationship
url https://doi.org/10.1186/s12883-025-04299-x
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