Abstract
Insulin resistance (IR) has been shown to be correlated with increased cancer risk. Nevertheless, few studies have explored the relationship between IR and small cell lung cancer (SCLC). The triglyceride glucose (TyG) index, TyG index with body mass index (TyG-BMI), triglyceride/high-density lipoprotein cholesterol ratio (TG/HDL-C), and metabolic score for IR (METS-IR) are recognized as reliable indicators for evaluating IR. In our investigation, 235 patients with pathologically confirmed SCLC were enrolled, along with 235 healthy individuals matched for age and sex as controls. Univariate binary logistic regression analyses revealed a significant association between elevated levels of all IR surrogates and the risk of SCLC. This finding persisted even after adjusting for other established high-risk factors. Concurrently, a progressive increase in the incidence of SCLC was observed across the tertiles of the TyG index, TyG-BMI, TG/HDL-C, and METS-IR. Furthermore, this article is the first to conclude that the four IR surrogates did not significantly differ across different stages of SCLC, implying that IR might exert a greater influence on the onset than on the progression of SCLC. Among these factors, TG/HDL-C has emerged as the most effective predictor of SCLC. Consequently, lifestyle modifications and pharmacological interventions should be actively pursued in individuals with IR to mitigate their risk of developing SCLC. Our findings also offer a promising avenue for the identification of novel therapeutic targets.