Potential of seven insulin resistance indicators as biomarkers to predict infertility risk in U.S. women of reproductive age: a cross-sectional study

Abstract Background Insulin resistance(IR) is a key mechanism underlying both obesity and metabolic syndrome, with significant implications for the onset and progression of female infertility. This study systematically examines the associations between seven insulin resistance indicators and the ris...

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Main Authors: Ruihua Yan, Jiao Zhang, Hongyun Ma, Yang Wu, Yang Fan
Format: Article
Language:English
Published: BMC 2025-05-01
Series:Reproductive Biology and Endocrinology
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Online Access:https://doi.org/10.1186/s12958-025-01416-w
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author Ruihua Yan
Jiao Zhang
Hongyun Ma
Yang Wu
Yang Fan
author_facet Ruihua Yan
Jiao Zhang
Hongyun Ma
Yang Wu
Yang Fan
author_sort Ruihua Yan
collection DOAJ
description Abstract Background Insulin resistance(IR) is a key mechanism underlying both obesity and metabolic syndrome, with significant implications for the onset and progression of female infertility. This study systematically examines the associations between seven insulin resistance indicators and the risk of infertility in U.S. women of reproductive age, while also evaluating the diagnostic value of these indicators in predicting infertility. Method This cross-sectional study analyzed data from the 2013–2018 National Health and Nutrition Examination Survey (NHANES) to explore the relationship between seven insulin resistance indicators and infertility risk. The indicators included the Metabolic Score for Insulin Resistance (METS-IR), Triglyceride-Glucose Index (TyG), Triglyceride-Glucose-Waist Circumference (TyG-WC), Triglyceride-Glucose-Body Mass Index (TyG-BMI), Triglyceride-Glucose-Waist-to-Height Ratio (TyG-WHtR), Homeostasis Model Assessment of Insulin Resistance (HOMA-IR), and Triglyceride/High-Density Lipoprotein Ratio (TG/HDL). Receiver Operating Characteristic (ROC) curves were used to assess the diagnostic accuracy of each insulin resistance indicator in predicting infertility. Additionally, smooth curve fitting and threshold effect analysis were employed to further explore the relationship between insulin resistance indicators with high diagnostic efficacy and infertility. Results This study included 1,100 women aged 20–45, of whom 140 (12.61%) were diagnosed with infertility. The results revealed significant positive correlations between METS-IR, TyG-BMI, TyG-WC, TyG-WHtR, and infertility risk. Specifically, as TyG-WC and TyG-WHtR levels increased, the risk of infertility rose linearly, while METS-IR and TyG-BMI exhibited a nonlinear positive association with infertility risk. No significant correlations were observed between TyG, HOMA-IR, TG/HDL, and infertility. Finally, ROC curve analysis indicated that METS-IR outperformed the other six insulin resistance indicators in predicting infertility risk. Conclusion METS-IR, TyG-BMI, TyG-WC, and TyG-WHtR are significantly associated with the risk of infertility in U.S. women of reproductive age, with METS-IR demonstrating the highest predictive power. These findings suggest that METS-IR may have substantial clinical utility in evaluating infertility risk.
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spelling doaj-art-e1d1a55fdce8496bb13deb20bfa119dd2025-08-20T01:53:20ZengBMCReproductive Biology and Endocrinology1477-78272025-05-0123111810.1186/s12958-025-01416-wPotential of seven insulin resistance indicators as biomarkers to predict infertility risk in U.S. women of reproductive age: a cross-sectional studyRuihua Yan0Jiao Zhang1Hongyun Ma2Yang Wu3Yang Fan4Department of Obstetrics and Gynecology, People’s Hospital of Ningxia Hui Autonomous Region, Ningxia Medical UniversityDepartment of Obstetrics and Gynecology, People’s Hospital of Ningxia Hui Autonomous Region, Ningxia Medical UniversityDepartment of Obstetrics and Gynecology, People’s Hospital of Ningxia Hui Autonomous Region, Ningxia Medical UniversityDepartment of Obstetrics and Gynecology, People’s Hospital of Ningxia Hui Autonomous Region, Ningxia Medical UniversityDepartment of Obstetrics and Gynecology, People’s Hospital of Ningxia Hui Autonomous Region, Ningxia Medical UniversityAbstract Background Insulin resistance(IR) is a key mechanism underlying both obesity and metabolic syndrome, with significant implications for the onset and progression of female infertility. This study systematically examines the associations between seven insulin resistance indicators and the risk of infertility in U.S. women of reproductive age, while also evaluating the diagnostic value of these indicators in predicting infertility. Method This cross-sectional study analyzed data from the 2013–2018 National Health and Nutrition Examination Survey (NHANES) to explore the relationship between seven insulin resistance indicators and infertility risk. The indicators included the Metabolic Score for Insulin Resistance (METS-IR), Triglyceride-Glucose Index (TyG), Triglyceride-Glucose-Waist Circumference (TyG-WC), Triglyceride-Glucose-Body Mass Index (TyG-BMI), Triglyceride-Glucose-Waist-to-Height Ratio (TyG-WHtR), Homeostasis Model Assessment of Insulin Resistance (HOMA-IR), and Triglyceride/High-Density Lipoprotein Ratio (TG/HDL). Receiver Operating Characteristic (ROC) curves were used to assess the diagnostic accuracy of each insulin resistance indicator in predicting infertility. Additionally, smooth curve fitting and threshold effect analysis were employed to further explore the relationship between insulin resistance indicators with high diagnostic efficacy and infertility. Results This study included 1,100 women aged 20–45, of whom 140 (12.61%) were diagnosed with infertility. The results revealed significant positive correlations between METS-IR, TyG-BMI, TyG-WC, TyG-WHtR, and infertility risk. Specifically, as TyG-WC and TyG-WHtR levels increased, the risk of infertility rose linearly, while METS-IR and TyG-BMI exhibited a nonlinear positive association with infertility risk. No significant correlations were observed between TyG, HOMA-IR, TG/HDL, and infertility. Finally, ROC curve analysis indicated that METS-IR outperformed the other six insulin resistance indicators in predicting infertility risk. Conclusion METS-IR, TyG-BMI, TyG-WC, and TyG-WHtR are significantly associated with the risk of infertility in U.S. women of reproductive age, with METS-IR demonstrating the highest predictive power. These findings suggest that METS-IR may have substantial clinical utility in evaluating infertility risk.https://doi.org/10.1186/s12958-025-01416-wFemale infertilityInsulin resistance-related indexesNHANES
spellingShingle Ruihua Yan
Jiao Zhang
Hongyun Ma
Yang Wu
Yang Fan
Potential of seven insulin resistance indicators as biomarkers to predict infertility risk in U.S. women of reproductive age: a cross-sectional study
Reproductive Biology and Endocrinology
Female infertility
Insulin resistance-related indexes
NHANES
title Potential of seven insulin resistance indicators as biomarkers to predict infertility risk in U.S. women of reproductive age: a cross-sectional study
title_full Potential of seven insulin resistance indicators as biomarkers to predict infertility risk in U.S. women of reproductive age: a cross-sectional study
title_fullStr Potential of seven insulin resistance indicators as biomarkers to predict infertility risk in U.S. women of reproductive age: a cross-sectional study
title_full_unstemmed Potential of seven insulin resistance indicators as biomarkers to predict infertility risk in U.S. women of reproductive age: a cross-sectional study
title_short Potential of seven insulin resistance indicators as biomarkers to predict infertility risk in U.S. women of reproductive age: a cross-sectional study
title_sort potential of seven insulin resistance indicators as biomarkers to predict infertility risk in u s women of reproductive age a cross sectional study
topic Female infertility
Insulin resistance-related indexes
NHANES
url https://doi.org/10.1186/s12958-025-01416-w
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