{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T08:53:43Z","timestamp":1791968023939,"version":"4.3.4"},"reference-count":41,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T00:00:00Z","timestamp":1791936000000},"content-version":"vor","delay-in-days":286,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["International Journal of Endocrinology"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Women with overweight or obesity are metabolically heterogeneous, and body mass index (BMI) alone does not fully characterise their endocrine and metabolic health. We examined associations between five insulin resistance surrogate indices and a component\u2010defined metabolically unhealthy phenotype (MUP) to characterise insulin resistance\u2013related metabolic variation in this population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This cross\u2010sectional analysis used the China Health and Nutrition Survey (CHNS) 2009 for discovery and the National Health and Nutrition Examination Survey (NHANES) 2011\u20132018 for independent replication. Final samples comprised 1751 CHNS and 2953 NHANES participants. The indices were homeostasis model assessment of insulin resistance (HOMA\u2010IR), triglyceride\u2013glucose index (TyG), triglyceride\u2010to\u2010high\u2010density lipoprotein cholesterol ratio (TG\/HDL\u2010C), triglyceride\u2013glucose body mass index (TyG\u2010BMI) and metabolic score for insulin resistance (METS\u2010IR). MUP was defined as at least two abnormal metabolic components. Modified Poisson regression estimated prevalence ratios (PRs) per 1\u2010standard\u2010deviation increment and across quartiles. Fully adjusted models included 1721 CHNS and 2799 NHANES participants. Receiver operating characteristic curves and areas under the curve (AUCs) provided a descriptive, exploratory assessment of internal discrimination.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      All five indices were positively associated with MUP in both datasets. Fully adjusted PRs per 1\u2010standard\u2010deviation increment ranged from 1.027 (95% confidence interval 1.011\u20131.043) for HOMA\u2010IR to 1.133 (1.110\u20131.157) for TyG in CHNS and from 1.058 (1.024\u20131.094) for TG\/HDL\u2010C to 1.168 (1.144\u20131.192) for TyG in NHANES. Positive quartile gradients were observed for all indices (\n                      <jats:italic>p<\/jats:italic>\n                      for trend &lt; 0.001). Exploratory internal discrimination for MUP showed different patterns across the two datasets.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Higher values of all five indices were associated with MUP among women with overweight or obesity in both datasets. These findings highlight the co\u2010occurrence of insulin resistance\u2013related glucose and lipid disturbances with clustered metabolic abnormalities. They support considering metabolic function alongside adiposity when characterising endocrine\u2010metabolic heterogeneity among women with overweight or obesity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/ije\/5660424","type":"journal-article","created":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T08:33:03Z","timestamp":1791966783000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Associations of Insulin Resistance Surrogate Indices With Component\u2010Defined Metabolically Unhealthy Phenotype Among Women With Overweight or Obesity: A Cross\u2010Sectional Analysis of CHNS and NHANES"],"prefix":"10.1155","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-2077-2305","authenticated-orcid":false,"given":"Xiaoye","family":"Zhu","sequence":"first","affiliation":[{"name":"School of Nursing Nanjing Medical University  101 Longmian Road Nanjing 211166 Jiangsu China  njmu.edu.cn"},{"name":"Department of Obstetrics The Affiliated Lihuili Hospital of Ningbo University  1111 Jiangnan Road Ningbo 315100 Zhejiang China  nbu.edu.cn"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6786-7053","authenticated-orcid":false,"given":"Jinghui","family":"Zou","sequence":"additional","affiliation":[{"name":"Department of Obstetrics The Affiliated Lihuili Hospital of Ningbo University  1111 Jiangnan Road Ningbo 315100 Zhejiang China  nbu.edu.cn"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hong","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Obstetrics The Affiliated Lihuili Hospital of Ningbo University  1111 Jiangnan Road Ningbo 315100 Zhejiang China  nbu.edu.cn"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Honghong","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Obstetrics The Affiliated Lihuili Hospital of Ningbo University  1111 Jiangnan Road Ningbo 315100 Zhejiang China  nbu.edu.cn"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9961-6195","authenticated-orcid":false,"given":"Yisheng","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Obstetrics The Affiliated Lihuili Hospital of Ningbo University  1111 Jiangnan Road Ningbo 315100 Zhejiang China  nbu.edu.cn"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6602-6655","authenticated-orcid":false,"given":"Yanfei","family":"Jin","sequence":"additional","affiliation":[{"name":"School of Nursing Nanjing Medical University  101 Longmian Road Nanjing 211166 Jiangsu China  njmu.edu.cn"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,14]]},"reference":[{"key":"e_1_2_15_1_2","doi-asserted-by":"publisher","DOI":"10.1210\/endrev\/bnaa004"},{"key":"e_1_2_15_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/s2213-8587(23)00086-4"},{"key":"e_1_2_15_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/s2213-8587(24)00316-4"},{"key":"e_1_2_15_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/circulationaha.109.192644"},{"key":"e_1_2_15_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/bf00280883"},{"key":"e_1_2_15_6_2","doi-asserted-by":"publisher","DOI":"10.1089\/met.2008.0034"},{"key":"e_1_2_15_7_2","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2010-0288"},{"key":"e_1_2_15_8_2","doi-asserted-by":"publisher","DOI":"10.1186\/1475-2840-10-93"},{"key":"e_1_2_15_9_2","doi-asserted-by":"publisher","DOI":"10.3390\/biomedicines12071493"},{"key":"e_1_2_15_10_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0149731"},{"key":"e_1_2_15_11_2","doi-asserted-by":"publisher","DOI":"10.1530\/eje-17-0883"},{"key":"e_1_2_15_12_2","doi-asserted-by":"publisher","DOI":"10.1111\/obr.12119"},{"key":"e_1_2_15_13_2","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyp322"},{"key":"e_1_2_15_14_2","first-page":"1","article-title":"National Health and Nutrition Examination Survey, 2015-2018: Sample Design and Estimation Procedures","volume":"2","author":"Chen T. C.","year":"2020","journal-title":"Vital Health Stat"},{"key":"e_1_2_15_15_2","first-page":"1","article-title":"National Health and Nutrition Examination Survey: Sample Design, 2011-2014","volume":"2","author":"Johnson C. L.","year":"2014","journal-title":"Vital Health Stat"},{"key":"e_1_2_15_16_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12872-024-03747-9"},{"key":"e_1_2_15_17_2","doi-asserted-by":"publisher","DOI":"10.1097\/ede.0000000000001544"},{"key":"e_1_2_15_18_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2105-12-77"},{"key":"e_1_2_15_19_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12874-024-02198-2"},{"key":"e_1_2_15_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacl.2024.04.130"},{"key":"e_1_2_15_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.numecd.2021.11.017"},{"key":"e_1_2_15_22_2","doi-asserted-by":"publisher","DOI":"10.1186\/1475-2840-7-4"},{"key":"e_1_2_15_23_2","doi-asserted-by":"publisher","DOI":"10.1089\/met.2010.0028"},{"key":"e_1_2_15_24_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0050931"},{"key":"e_1_2_15_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.metabol.2011.09.009"},{"key":"e_1_2_15_26_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12944-021-01532-7"},{"key":"e_1_2_15_27_2","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2024.1362667"},{"key":"e_1_2_15_28_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12933-024-02334-8"},{"key":"e_1_2_15_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmet.2024.03.002"},{"key":"e_1_2_15_30_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12902-026-02424-6"},{"key":"e_1_2_15_31_2","doi-asserted-by":"publisher","DOI":"10.1172\/jci78425"},{"key":"e_1_2_15_32_2","doi-asserted-by":"publisher","DOI":"10.1161\/circulationaha.105.169404"},{"key":"e_1_2_15_33_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cell.2015.01.012"},{"key":"e_1_2_15_34_2","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.0904944106"},{"key":"e_1_2_15_35_2","doi-asserted-by":"publisher","DOI":"10.1172\/jci5286"},{"key":"e_1_2_15_36_2","doi-asserted-by":"publisher","DOI":"10.1152\/ajpheart.00092.2005"},{"key":"e_1_2_15_37_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2023.2145"},{"key":"e_1_2_15_38_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41574-024-01008-5"},{"key":"e_1_2_15_39_2","doi-asserted-by":"publisher","DOI":"10.2337\/dc07-0358"},{"key":"e_1_2_15_40_2","doi-asserted-by":"publisher","DOI":"10.1152\/ajpendo.1979.237.3.E214"},{"key":"e_1_2_15_41_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-014-3285-x"}],"container-title":["International Journal of Endocrinology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/ije\/5660424","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1155\/ije\/5660424","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/ije\/5660424","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T08:33:09Z","timestamp":1791966789000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1155\/ije\/5660424"}},"subtitle":[],"editor":[{"given":"Neetu","family":"Rawal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":41,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1155\/ije\/5660424"],"URL":"https:\/\/doi.org\/10.1155\/ije\/5660424","archive":["Portico"],"relation":{},"ISSN":["1687-8337","1687-8345"],"issn-type":[{"value":"1687-8337","type":"print"},{"value":"1687-8345","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"assertion":[{"value":"2026-07-01","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-25","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-14","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"5660424"}}