Volume 46 Issue 10
Oct.  2025
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LIU Jianxi, SHI Longkai, CHEN Linlin, XU Yingli, DING Wenqing. Association of metabolic score for insulin resistance with bone mineral content and bone metabolic markers among adolescents[J]. CHINESE JOURNAL OF SCHOOL HEALTH, 2025, 46(10): 1498-1502. doi: 10.16835/j.cnki.1000-9817.2025299
Citation: LIU Jianxi, SHI Longkai, CHEN Linlin, XU Yingli, DING Wenqing. Association of metabolic score for insulin resistance with bone mineral content and bone metabolic markers among adolescents[J]. CHINESE JOURNAL OF SCHOOL HEALTH, 2025, 46(10): 1498-1502. doi: 10.16835/j.cnki.1000-9817.2025299

Association of metabolic score for insulin resistance with bone mineral content and bone metabolic markers among adolescents

doi: 10.16835/j.cnki.1000-9817.2025299
  • Received Date: 2025-06-23
  • Rev Recd Date: 2025-08-08
  • Publish Date: 2025-10-25
  •   Objective  To investigate the relationship of metabolic score for insulin resistance (METS-IR) with bone mineral content (BMC) and bone metabolic markers levels among adolescents, so as to provide a scientific foundation for the early identification and prevention of bone-related diseases.  Methods  From 2017 to 2019 and 2023, a total of 1 414 adolescents aged 12-18 years from Yinchuan were selected using a method combining convenient sampling with stratified cluster random sampling. The data of basic information, body mass index, BMC, serum osteocalcin (OC), type Ⅰ collagen cross-linked C-terminal peptide (CTX) and calcium (Ca), METS-IR among adolescents were obtained by questionnaire survey, physical measurement and laboratory examination, and METS-IR was divided into four groups Q1-Q4 according to P25, P50 and P75. Logistic regression models combined with restricted cubic splines were employed to analyze the relationship between METS-IR and low BMC as well as low bone metabolic markers. The receiver operating characteristic (ROC) curve was used to evaluate METS-IR effectiveness in diagnosing low BMC.  Results  The levels of BMC, OC, CTX, Ca and METS-IR in the surveyed adolescents were (2.66±0.52)kg, (20.49±13.77)ng/mL, (2 460.89±1 818.96)pg/mL, (2.47±0.67)mmol/L, 30.63±7.58. After adjusting for gender, age and physical activity level, METS-IR in Q4 group had a reduced risk of low BMC and low CTX [OR (95%CI)=0.03(0.01-0.07), 0.45(0.32-0.65)] and an elevated risk of low OC [OR (95%CI)=1.85(1.28-2.67)], compared with the Q1 group (all P < 0.05). Gender-stratified analyses revealed similar trends for both males and females (all P < 0.05). Non-linear dose-response relationships were observed between METS-IR and low BMC (Ptotal trend < 0.01, Pnon-linearity=0.01), as well as low OC (Ptotal trend < 0.01, Pnon-linearity=0.01), while a linear relationship was detected with low CTX (Ptotal trend < 0.01, Pnon-linearity=0.72). ROC curves revealed that METS-IR had the best diagnostic performance for low BMC (AUC=0.85, 95%CI=0.82-0.88, P < 0.01).  Conclusions  Higher METS-IR score is linked to reduced risk of low BMC and CTX but increase risk of low OC among adolescents. These findings suggest METS-IR is a reliable indicator for assessing BMC and early predicting bone health risk among adolescents.
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