Please use this identifier to cite or link to this item:http://hdl.handle.net/20.500.12105/19335
Title
Early insulin resistance in normoglycemic low-risk individuals is associated with subclinical atherosclerosis.
Author(s)
Iglesies-Grau, Josep | Garcia-Alvarez, Ana CNIC | Oliva, Belen CNIC | Mendieta, Guiomar | Garcia-Lunar, Ines CNIC | Fuster, Jose J. CNIC | Devesa, Ana | Pérez-Herreras, Cristina | Fernandez-Ortiz, Antonio CNIC | Brugada, Ramon CNIC | Ibáñez, Borja CNIC | Fernandez-Jimenez, Rodrigo CNIC | Fuster, Valentin
Date issued
2023-12-19
Citation
Cardiovasc Diabetol. 2023 Dec 19;22(1):350.
Language
Inglés
Document type
journal article
Abstract
BACKGROUND
Elevated glycated hemoglobin (HbA1c) is associated with a higher burden of subclinical atherosclerosis (SA). However, the association with SA of earlier insulin resistance markers is poorly understood. The study assessed the association between the homeostatic model assessment of insulin resistance index (HOMA-IR) and SA in addition to the effect of cardiovascular risk factors (CVRFs) in individuals with normal HbA1c.
METHODS
A cohort of 3,741 middle-aged individuals from the Progression of Early Subclinical Atherosclerosis (PESA) study with basal HbA1c < 6.0% (< 42 mmol/mol) and no known CV disease underwent extensive imaging (multiterritorial vascular ultrasound and coronary artery calcium score, CACS) to assess the presence, burden, and extent of SA.
RESULTS
Individuals with higher HOMA-IR values had higher rates of CVRFs. HOMA-IR showed a direct association with the multiterritorial extent of SA and CACS (p < 0.001) and with global plaque volume measured by 3-dimensional vascular ultrasound (p < 0.001). After adjusting for key CVRFs and HbA1c, HOMA-IR values ≥ 3 were associated with both the multiterritorial extent of SA (odds ratio 1.41; 95%CI: 1.01 to 1.95, p = 0.041) and CACS > 0 (odds ratio 1.74; 95%CI: 1.20 to 2.54, p = 0.004), as compared with the HOMA-IR < 2 (the reference HOMA-IR category). In a stratified analysis, this association remained significant in individuals with a low-to-moderate SCORE2 risk estimate (75.6% of the cohort) but not in high-risk individuals.
CONCLUSIONS
The use of HOMA-IR identified low-risk individuals with a higher burden of SA, after adjusting for the effects of key traditional CVRFs and HbA1c. HOMA-IR is a simple measure that could facilitate earlier implementation of primary CV prevention strategies in clinical practice.
MESH
Insulin Resistance | Atherosclerosis | Plaque, Atherosclerotic | Middle Aged | Humans | Glycated Hemoglobin | Risk Factors
Online version
DOI
Collections