Sex Differences in the Associations among Insulin Resistance Indexes with Metabolic Syndrome: A Large Cross-Sectional Study.

Purpose: Metabolic syndrome (MetS) is closely related to insulin resistance (IR), and the sex differences have not been fully explored. This study was aimed to investigate the sex differences in the associations among IR indexes with MetS in a large population. Methods: A total of 60,799 participants were enrolled in the current study. MetS was defined using the National Cholesterol Education Program Adult Treatment Panel III criteria. The following IR indexes were evaluated: triglyceride-glucose (TyG) index, TyG-waist circumference (TyG-WC), TyG-waist to height ratio (TyG-WHtR), TyG-body mass index (TyG-BMI), triglyceride to high-density lipoprotein cholesterol (TG/HDL-C), and metabolic score for IR (MetS-IR). Factors associated with MetS were examined using logistic regressions. The receiver operating characteristic curves were used to evaluate the predictive value of the IR indexes for MetS. Results: The prevalence of MetS was 11.8% ( Conclusions: The IR index levels are higher in male than female patients. In IR indexes, TyG has the highest AUC in male patients and TyG-WHtR in female patients. The combination of IR indexes improved diagnostic efficiency compared with a single parameter. Moreover, the IR indexes are independently associated with MetS except for TyG-WHtR and TG/HDL-C in female patients. Our findings indicate that the multi-index association of IR indexes may play a potential role in MetS diagnosis, and understanding the sex differences in risk factors for MetS may help doctors properly implement more individualized prevention strategies.