Relation between insulin resistance and carotid intima-media thickness and stenosis in non-diabetic subjects. Results from a cross-sectional study in Malmo, Sweden (original) (raw)
Related papers
Journal of Internal Medicine, 2001
Bokemark L, Wikstrand J, Attvall S, Hulthe J, Wedel H, Fagerberg B (Sahlgrenska University Hospital, and the Nordic School of Public Health, Go Èteborg, Sweden). Insulin resistance and intima± media thickness in the carotid and femoral arteries of clinically healthy 58-year-old men. The Atherosclerosis and Insulin Resistance Study (AIR). J Intern Med 2001; 249: 59±67. P , 0.05), log triglycerides (r = 0.28, P , 0.01), apoA 1 (r = 2 0.20, P , 0.05), apoB (r = 0.21, P , 0.05), LDL particle size (r = 2 0.22, P , 0.05) and plasma insulin (r = 0.20, P , 0.05). In a multiple regression, common carotid IMT was independently associated with log triglycerides (b = 0.25, P = 0.012) and pulse pressure (b = 0.21, P = 0.031) (R 2 = 8.7%, P = 0.005) Conclusions. Insulin sensitivity, measured with the gold standard euglycaemic hyperinsulinaemic clamp method, showed similar associations with ultrasound-assessed measures of atherosclerosis in the carotid arteries as established cardiovascular risk factors, but only triglycerides and pulse pressure contributed independently to the variability in the common carotid intima±media thickness.
Relationship between insulin resistance and accumulation of coronary risk factors
Diabetes, Obesity and Metabolism, 2002
We examined correlations between the frequency of insulin resistance and the accumulation of coronary risk factors in residents of rural comities in Japanese, using simple criteria for determination of insulin resistance based on evaluation by the euglycaemic-hyperinsulinaemic glucose clamp (GC) method. The subjects were 376 men and 589 women living in two rural communities in Japan. We measured body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), triglyceride (TG), HDL cholesterol (HDL), and homeostasis model assessment (HOMA-R). Correlations between HOMA-R and those parameters were examined. To assess the existence of insulin resistance in these subjects, we used a practical index based on the GC method. The subjects with value of HOMA-R ! 1.73 have insulin resistance. In addition, the HOMA-R was divided into five quantiles based on the frequency distribution (0.60 or below, from 0.61 to 0.82, from 0.83 to 1.18, from 1.19 to 1.69, and 1.70 or higher), to examine the concentration of risk factors in each group. In total, 74 (19.6%) of the men and 119 (20.3%) of the women had insulin resistance (HOMA-R ! 1.73). It was found that the higher the HOMA-R, the higher was the number of coronary risk factors, such as hypertension, obesity, hypertriglyceridaemia and hypo HDL cholesterolaemia. The number of coronary risk factors was particular high in subjects with HOMA-R ! 1.70. HOMA-R in the case of no glucose loading is a useful and practical index for evaluation of insulin resistance and coronary risk factors in the epidemiological study.
… , and vascular biology, 2003
Objective-We examined the possible association between insulin resistance and carotid arteriosclerosis in subjects who had both normal fasting glucose and normal glucose tolerance after intake of a glucose load. Methods and Results-Our subjects were individuals who underwent general health screening at our institute, which included carotid ultrasound and oral glucose tolerance testing. Of the 1238 subjects enrolled in our study, 738 (60%) were classified as normal, defined as a normal fasting glucose level and normal glucose tolerance, and 334 (27%) and 166 (13%) were classified as borderline and diabetic, respectively, according to the criteria of the Japan Diabetes Society. The homeostasis model assessment of insulin resistance (HOMA-IR) was used as the index to measure insulin resistance. In normal-type subjects, univariate analysis showed that insulin resistance, but not insulin secretion, was associated with the presence of carotid plaque. Multivariate analysis showed that HOMA-IR was positively associated with carotid plaque in normal-type subjects, with an odds ratio of 1.19 (95% confidence interval, 1.00 to 1.41; PϽ0.05). Conclusions-These data suggest the possibility that the presence of higher insulin resistance could be a risk factor for carotid arteriosclerosis in subjects with normal fasting glucose and normal glucose tolerance.
Arteriosclerosis, Thrombosis, and Vascular Biology, 2013
Objective— Despite a wealth of experimental data in animal models, the independent association of insulin resistance with early carotid atherosclerosis in man has not been demonstrated. Approach and Results— We studied a European cohort of 525 men and 655 women (mean age, 44±8 years) free of conditions known to affect carotid wall (diabetes mellitus, hypertension, and dyslipidemia). All subjects received an oral glucose tolerance test, a euglycemic hyperinsulinemic clamp (M/I as a measure of insulin sensitivity), and B-mode carotid ultrasound. In 833 participants (380 men), the carotid ultrasound was repeated after 3 years. In men, baseline intima-media thickness in the common carotid artery (CCA-IMT) was significantly higher ( P <0.05) in the lowest M/I tertile, whereas in women CCA-IMT was higher ( P <0.0005) in the highest fasting plasma glucose tertile (after adjustment for established risk factors). In multiple regression models, with CCA-IMT as the dependent variable and...
The Insulin Resistance Atherosclerosis Study (IRAS)
Annals of Epidemiology, 1995
The brsulin Resistance Achero&rosis Study (IRS) is the first epidemiologic study designed to assess the relationships between insulin resistance, insulinemia, glycemia, other components of the insulin resistance syndrome, and prevalent cardiwascular disease (CVD) in a large multiethnic cohort. Over I 600 men and women were recruited from four geographic areas to represent a range of glucose tolerance (normal, impaired, and diabetic) and ethnic@ (hispanic, non-Hispanic white, and African-American). Insulin resistance was assessed directly using the frequently sampled intravenous glucose tolerance test with minimal model analysis. lntimal-medial carotid artery wall thickness, an indicator ofathero sclerosis, was measured using &mode ultrasonography. Prevalent CVD was assessed by questionnaire and resting electrocardiography. This report describes the design of the study and provides the recruitment results. Forthcoming cross-sectional analyses will help to disentangle the association between insulin resistance and CVD, apart from the concomitant hyperinsulinemia and related CVD risk factors. Ann Epidemiol 1995;5:464-472.
1997
The aim of this study was 1) to compare intimal-medial thickness (IMT) of the carotid artery in nondiabetic and NIDDM patients and 2) to evaluate the association of this early marker of atherosclerosis with several cardiovascular risk factors, including plasma insulin and insulin resistance. RESEARCH DESIGN A N D METHODS-A total of 58 nondiabetic and 56 NIDDM patients, randomly selected among those attending the outpatient Diabetes Clinic or the Clinic for Internal Medicine were examined. BM1, waist-to-hip ratio (WHR), blood pressure, glycohemoglobin (HbA lc), and fasting concentrations of plasma glucose, serum lipids (total and HDL cholesterol, triglycerides), and serum insulin were measured. Insulin resistance was assessed by computing glucose disappearance rate from plasma after intravenous insulin injection (K Ut). IMT of the carotid artery was measured by ultrasonography. RESULTS-IMT was significantly higher in diabetic patients, and the difference remained highly significant after adjusting for sex, age, BMI, WHR, presence of hypertension and dyslipidemia, and smoking status (1.39 vs. 1.24 mm, common SD 0.12, P < 0.001). Univariate regression analyses showed that IMT was negatively correlated with K itt in either nondiabetic (r =-0.348, P < 0.01) or diabetic patients (r =-0.492, P < 0.001). However, multiple regression analyses showed that IMT was independently associated with age and WHR in nondiabetic subjects, whereas in diabetic patients, IMT was independently predicted by K itt and hypertension. These two variables explained-62% and ~35% of the variability of IMT in nondiabetic and diabetic patients, respectively. Plasma insulin was not independently associated with IMT in either groups. CONCLUSIONS-These results indicate that I) diabetes is characterized by a greater thickness of the carotid artery independently of other established risk factor of atherosclerosis, 2) early atherosclerosis is independently associated with insulin resistance in diabetic but not in nondiabetic patients, 3) central adiposity is an independent predictor of IMT in nondiabetic individuals. A bout 15 years ago epidemiological prospective studies (Paris Prospective Study, Busselton Study, and Helsinki Policemen Study) reported that hyperinsulinemia can predict coronary heart disease, independently of the presence of diabetes, dyslipidemia, and hypertension (1-3). Despite several inconsistencies within and between these studies, especially in extended follow-up examinations (4-7), From the Division of Metabolic Diseases (E.
Insulin resistance and coronary artery disease in non-diabetic patients: Is there any correlation
Caspian Journal of Internal Medicine, 2018
Background: Cardiovascular diseases are the most common causes of death in the world and type 2 diabetes is one of them because it is highly prevalent and doubles heart disease risk. Some studies suggest that insulin resistance is associated with coronary artery disease in non-diabetics. The aim of this study was to evaluate the association of insulin resistance (IR) and coronary artery disease (CAD) in non-diabetic patients. Methods: In this cross-sectional study, from September 2014 to July 2015, 120 patients referring to Shahid Beheshti Hospital of Qom were evaluated. Their medical history, baseline laboratory studies, BMI and GFR were recorded. After 8 hours of fasting, blood samples were taken from the patients at 8 am, including fasting glucose and insulin level. We estimated insulin resistance using the homeostatic model assessment index of IR (HOMA-IR). Finally, we evaluated the association between IR and CAD. Results: Totally, 120 patients were assigned to participate in this study, among them, 50 patients without CAD and 70 with coronary artery stenosis. Insulin resistance (HOMA-IR> 2.5) was positive in 59 (49.3%) patients and negative in 61 (50.7%) patients. Hence, the correlation between IR and CAD was not statistically significant (P=0.9). Conclusions: In this study, although the correlation was not found between insulin resistance and coronary heart disease, among men, we found a significant association between coronary heart disease and insulin resistance.
The degree of coronary atherosclerosis as a marker of insulin resistance in non-diabetics
Srpski arhiv za celokupno lekarstvo, 2010
Introduction. The metabolic syndrome and its influence on coronary artery disease development and progression remains in focus of international research debates, while insulin resistance, which represents its core, is the key component of hypertension, dyslipidaemias, glucose intolerance and obesity. Objective. The aim of this study was to establish relationship between basal glucose and insulin levels, insulin sensitivity and lipid panel and the degree of coronary atherosclerosis in nondiabetic patients. Methods. The coronary angiograms were evaluated for the presence of significant stenosis, insulin sensitivity was assessed using the intravenous glucose tolerance test with a minimal model according to Bergman, while baseline glucose (G0), insulin (I0) and lipid panel measurements (TC, HDL, LDL, TG) were taken after a 12-hour fasting. Results. The protocol encompassed 40 patients (19 men and 21 women) treated at the Institute for Cardiovascular Diseases of the Clinical Centre of Se...
Diabetes/Metabolism Research and Reviews, 2001
Objective Atherosclerosis is associated with insulin resistance (IR) and dyslipidaemia. Impaired glucose tolerance (IGT) is characterised by IR and is associated with a higher risk of atherosclerosis. The objective of the present study was to test whether early atherosclerosis indicated by intimal medial thickness (IMT) of common carotid artery (CCA) and internal carotid artery (ICA) is higher in IGT than in normoglycaemic subjects (NGT) and to look for an association of IMT with IR and dyslipidaemia.
Diabetic Medicine, 2002
Aims To examine the relationship between specific (intact) insulin, insulin propeptides and subclinical atherosclerosis. Methods A cross-sectional study based on a stratified sampling of randomly selected, clinically healthy 58-year-old men (n = 391). Ultrasound examinations of the carotid arteries were performed with measurement of intima-media thickness (IMT) in the common carotid artery and in the carotid artery bulb. Fasting, cross-reacting plasma insulin (RIA), specific (intact) insulin, proinsulin, 32,33 split proinsulin and C-peptide were measured. Results Plasma concentrations of cross-reacting plasma insulin, specific insulin, proinsulin, 32,33 split proinsulin and C-peptide were univariately associated with common carotid artery IMT. Established risk factors such as blood pressure, smoking, apoB, triglycerides, body mass index (BMI), and waist-hip ratio were also related to IMT. After adjustment for smoking, apoB, blood pressure and triglycerides, cross-reacting plasma insulin, proinsulin and C-peptide but not specific insulin and split 32,33 proinsulin remained associated with carotid artery IMT. No associations remained after adjustment for BMI. Conclusions Fasting plasma proinsulin, C-peptide, and insulin by cross-reacting RIA was associated with common carotid artery IMT independent of several conventional risk factors for atherosclerosis. The multicollinearity between the insulin peptides and propeptides makes it difficult to clarify the exact role of each peptide.