Association between insulin resistance-related lipid indices and arthritis: a U. S. cross-sectional study

Abstract

Objectives: Arthritis is a degenerative disease that causes a huge social burden. Lipid-related molecules participate in the inflammatory response process of arthritis and are closely related to the pathological process of arthritis. Lipid-related indicators are easily available and have great potential in predicting arthritis. This study used cross-sectional data to explore lipid-related indicators and arthritis risk.

Methods: 18,683 participants were involved in this study, selected from the NHANES database covering the period from 2001 to 2018. The study utilized multivariate regression models to examine the association between various lipid-related parameters (including the TyG index, TyG-WC index, TyG-WHtR index, TyG-BMI index, HOMA-IR index, VAI index, and LAP index) and arthritis.

Results: After taking into account and appropriately addressing potential confounding variables and factors, all seven lipid-related indicators were positively associated with arthritis risk, and there was a significant difference in the highest quartile of seven lipid-related indicators compared with the lowest quartile (P < 0.001). Among them, the area under the ROC curve (AUC) of TyG-WC, TyG-WHtR, TyG-BMI, and LAP was >0.6, indicating they had modest accuracy in predicting arthritis. Logistic regression analysis showed that the best Cut-off values for predicting arthritis for these indicators were as follows: TyG: 8.45 [Odds ratio (95% Cl) = 1.77 (1.62, 1.94)]; TyG-WC: 850.39 [Odds ratio (95% Cl) = 1.36 (1.24, 1.49)]; TyG-WHtR: 4.97 [Odds ratio (95% Cl) = 2.39 (2.17, 2.63)]; TyG-BMI: 255.24 [Odds ratio (95% Cl) = 1.87 (1.71, 2.05)]; HOMA-IR: 2.79 [Odds ratio (95% Cl) = 1.51 (1.39, 1.65)]; VAI: 1.35 [Odds ratio (95% Cl) = 1.60 (1.47, 1.75)]; LAP: 33.46 [Odds ratio (95% Cl) = 1.20 (1.09, 1.31)], both P-values are < 0.001.

Conclusions: The results showed that seven lipid-related markers were positively associated with arthritis risk. Enhancing the management of glucose, lipids, and insulin sensitivity may significantly reduce the risk of arthritis.

Keywords: NHANES; TyG; arthritis; cross-sectional study; insulin resistance.

Figure 1

Participant screening flowchart.

Figure 2

Restricted cubic splines reflected the dose-response relationship between lipid-related markers and arthritis. Models were adjusted for sex, age, race, education, coronary heart disease, stroke, smoke, hypertension, TC, AST, and ALT. Horizontal coordinates represent the seven lipid-related indices and vertical coordinates represent the ORs for arthritis. An overall P value of < 0.001 indicates a significant association and a non-linear association P value >0.05 indicates a linear dose-response relationship.

Figure 3

Displays the ROC curve utilized in assessing the predictive capability of lipid-related markers for arthritis and IR. In particular, (A) illustrates the ROC curve concerning 7 lipid-related indicators for arthritis evaluation, while (B) illustrates the ROC curve for the evaluation of IR based on 6 lipid-related indicators, with the exclusion of HOME-IR.

Figure 4

Logistic regression analysis plot of TyG-WHtR. OR: odds ratio, 95% CI: 95% confidence interval, Model 1:unadjusted, Model 2: adjusted for sex, age and race, Model 3: adjusted for sex, age, race, education, coronary heart disease, stroke, smoke, hypertension, TC, AST, and ALT.