AimsTo investigate the association of single‐point insulin sensitivity estimator (SPISE) index with future cardiovascular outcomes in patients with type 2 diabetes.Materials and MethodsSPISE index (= 600 × high‐density lipoprotein cholesterol [mg/dL]0.185/triglycerides [mg/dL]0.2 × body mass index [kg/m2]1.338) was calculated in 10 190 participants. Cox proportional hazard regression models were applied to evaluate the association between SPISE index and future cardiovascular outcomes. Restricted cubic spline analyses and two‐piecewise linear regression models were employed to explore the nonlinear association and to determine the threshold value. Subgroup and interaction analyses were conducted to test the robustness of the results.ResultsAfter fully adjusting for well‐established metabolic confounders, higher SPISE index was significantly associated with lower risk of future cardiovascular outcomes in patients with type 2 diabetes (major adverse cardiovascular event [MACE]): hazard ratio [HR] 0.94, 95% confidence interval [CI] 0.90–0.98, p = 0.0026; overall mortality: HR 0.90, 95% CI 0.86–0.93, p < 0.0001; cardiovascular disease [CVD] mortality: HR 0.85, 95% CI 0.79–0.92, p < 0.0001; congestive heart failure (CHF): HR 0.72, 95% CI 0.67–0.78, p < 0.0001; major coronary events: HR 0.91, 95% CI 0.87–0.95, p < 0.0001. There was a nonlinear association between SPISE index and future cardiovascular outcomes (the threshold value was 5.68 for MACE, 5.71 for overall mortality, 4.64 for CVD mortality, 4.48 for CHF, and 6.09 for major coronary events, respectively).ConclusionsHigher SPISE index was independently associated with lower risk of future cardiovascular outcomes in type 2 diabetes patients after full adjustment for well‐established metabolic confounders.

中文翻译：

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单点胰岛素敏感性估计指数 (SPISE) 与 2 型糖尿病患者未来心血管结局的关系

目的探讨单点胰岛素敏感性估计量 (SPISE) 指数与 2 型糖尿病患者未来心血管结局的关系。 材料和方法 SPISE 指数（= 600 × 高密度脂蛋白胆固醇 [mg/dL]0.185/甘油三酯 [mg/dL]0.2× 体重指数 [kg/m2]1.338）以 10 190 名参与者计算。应用 Cox 比例风险回归模型评估 SPISE 指数与未来心血管结局之间的关联。采用限制三次样条分析和两段线性回归模型来探索非线性关联并确定阈值。进行亚组和交互分析以测试结果的稳健性。结果在充分调整已确定的代谢混杂因素后，较高的 SPISE 指数与 2 型糖尿病患者未来心血管结局风险较低显着相关（主要不良心血管事件 [MACE]） ])：风险比 [HR] 0.94，95% 置信区间 [CI] 0.90–0.98，p= 0.0026;总死亡率：HR 0.90，95% CI 0.86–0.93，p< 0.0001；心血管疾病 [CVD] 死亡率：HR 0.85，95% CI 0.79–0.92，p< 0.0001；充血性心力衰竭 (CHF)：HR 0.72，95% CI 0.67–0.78，p< 0.0001；主要冠状动脉事件：HR 0.91，95% CI 0.87–0.95，p< 0.0001。 SPISE指数与未来心血管结局之间存在非线性关联（MACE的阈值为5.68，总体死亡率为5.71，CVD死亡率为4.64，CHF为4.48，主要冠状动脉事件为6.09）。结论 SPISE指数较高与在对已确定的代谢混杂因素进行充分调整后，与 2 型糖尿病患者未来心血管结局风险较低相关。