Sex differences in the predictive value of insulin resistance surrogate indicators for prediabetes among Chinese adults aged 18–45 years: a multicenter cohort study

Category	Detail
Condition	Prediabetes
Key Mechanisms	Insulin resistance as a core pathophysiological driver
Target Population	Chinese adults aged 18 to 45
Care Setting	Multicenter retrospective cohort study

8.31% of participants developed prediabetes during follow-up, with higher incidence in men (10.76%) than women (5.74%)
METS-IR showed the strongest association with incident prediabetes in women (HR: 7.82) compared to men (HR: 1.45)
TyG-BMI demonstrated the highest predictive accuracy in the overall population (AUC = 0.6497)
Women exhibited superior discriminative performance across all insulin resistance indices compared to men
The study emphasizes the need for sex-specific risk stratification in prediabetes screening

Regular follow-up for individuals identified at risk using insulin resistance indices

Higher risk of progression to type 2 diabetes mellitus and cardiovascular complications in prediabetic individuals

Young Chinese adults aged 18 to 45 with normoglycemia at baseline

Focus on early identification of high-risk individuals to prevent metabolic deterioration

Clinical Scorecard: Gender-Based Variations in the Predictive Utility of Insulin Resistance Surrogates for Prediabetes in Chinese Adults Aged 18 to 45: Findings from a Multicenter Cohort Analysis