Comparing the associations of eight surrogate markers of insulin resistance with rapid decline in kidney function and the incidence of CKD in Chinese middle-aged and elderly non-diabetic population

Estimated glucose disposal rate (eGDR), lipid accumulation product, Chinese visceral adiposity index, triglyceride-glucose, TyG-body mass index, TyG-waist circumference (TyG-WC), metabolic score for insulin resistance (METS-IR), and atherogenic index of plasma (AIP) are considered surrogate markers of insulin resistance (IR). However, there is currently a lack of comparative studies on the ability of different surrogate markers of insulin resistance to predict rapid decline in kidney function and the occurrence of chronic kidney disease (CKD) in non-diabetic populations. This study is based on data from the China Health and Retirement Longitudinal Study (CHARLS). Multivariable logistic regression models and trend regression analyses were used to examine the relationships between eight surrogate markers of insulin resistance and rapid decline in kidney function as well as the risk of CKD. Finally, the area under the curve of the surrogate markers of insulin resistance was calculated using receiver operating characteristic analysis. Each one SD increase in AIP was significantly associated with a reduced risk of rapid decline in kidney function and CKD, with adjusted ORs of 1.391 and 1.560, respectively. Dose-response analysis revealed nonlinear associations between TyG-WC and METS-IR with the risk of rapid decline in kidney function, and between eGDR and TyG-WC with CKD (P nonlinearity ≥ 0.05). ROC analysis indicated that AIP had significantly higher AUC values for predicting the risk of rapid decline in kidney function and CKD in the non-diabetic population, with AUCs of 0.676 and 0.608, respectively. AIP demonstrates strong potential in predicting the risk of rapid decline in kidney function and CKD in the Chinese middle-aged and elderly non-diabetic population, and this predictive ability is not influenced by sex or age.