Associations of TNF-α, Uric Acid, and the Leptin/Adiponectin Ratio with HOMA-IR in Hospitalized Adults: A Cross-Sectional Secondary Analysis of 147 Patients
Abstract
Background and Objectives: Anthropometric measures incompletely capture the inflammatory and adipokine heterogeneity underlying insulin resistance. We examined associations of tumor necrosis factor-alpha (TNF-α), serum uric acid, and the leptin/adiponectin ratio with HOMA-IR after adjustment. Materials and Methods: This single-center cross-sectional secondary analysis included 147 of 239 hospitalized adults with HOMA-IR and predefined core data; fasting glucose, insulin, and biomarker testing was elective and patient-funded. Continuous ln(HOMA-IR) was the primary outcome. A secondary upper-quartile phenotype (HOMA-IR ≥ 4.78; n = 37) was cohort-specific and non-diagnostic. Robust linear regression used HC3 standard errors. Sensitivity analyses excluded T2DM and replaced BMI with waist circumference or visceral fat area. Binary and AUC analyses were exploratory (expanded complete-case model, n = 112). Results: Each doubling of (TNF-α + 1) was associated with a 10.2% higher HOMA-IR in the expanded model (p = 0.021). The association persisted after excluding T2DM (12.1% higher HOMA-IR per doubling; n = 81; p = 0.012) and when BMI was replaced by waist circumference (p = 0.022) or visceral fat area (p = 0.018). Uric acid and the leptin/adiponectin ratio did not reach statistical significance in the adjusted continuous-outcome model. The 112 complete cases and 35 incomplete cases were broadly similar in measured baseline characteristics, although uric acid was higher among…
How strong is the evidence?
Evidence Hub reads this as a secondary / pooled analysis, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 239 participants or records.
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