Insulin Resistance Indices Predict Mortality in Cardiovascular Disease: A Large-Scale NHANES Study With Machine Learning Validation.

ABSTRACT: Insulin resistance (IR) is a key driver of cardiovascular disease (CVD), the leading cause of global mortality. This study evaluated the prognostic value of two surrogate IR indices-the McAuley index and the Metabolic Score for Insulin Resistance (METS-IR)-for predicting all-cause and CVD mortality. Data from 22,308 NHANES participants with established CVD (1999-2018) was analyzed. Outcomes were all-cause and CVD mortality. Cox proportional hazards models and restricted cubic splines assessed associations, while machine learning methods (random forest, XGBoost, CoxBoost, DeepHit) evaluated predictive performance. Model interpretability was assessed using SHapley Additive exPlanations (SHAP). Over a median 9.2-year follow-up, 3484 deaths occurred, including 1093 from CVD. A higher McAuley I

SUBMITTER: Zhou Z 

PROVIDER: S-EPMC12628084 | biostudies-literature | 2025 Nov

REPOSITORIES: biostudies-literature