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Diabetes Care. 2011 Mar;34(3):749-51. doi: 10.2337/dc10-1681. Epub 2011 Feb 3.

The relationship between insulin resistance and incidence and progression of coronary artery calcification: the Multi-Ethnic Study of Atherosclerosis (MESA).

Author information

  • 1Johns Hopkins Ciccarone Preventive Cardiology Center, Baltimore, Maryland. mblaha1@jhmi.edu

Abstract

OBJECTIVE:

We sought to determine whether insulin resistance predicts the incidence and progression of coronary artery calcification (CAC).

RESEARCH DESIGN AND METHODS:

We studied 5,464 participants not on hypoglycemic therapy from the Multi-Ethnic Study of Atherosclerosis (MESA). Each had baseline homeostasis model assessment of insulin resistance (HOMA-IR) and baseline and follow-up CAC scores. Incident CAC was defined as newly detectable CAC; progression was defined as advancing CAC volume score at follow-up.

RESULTS:

Median HOMA-IR was 1.2 (0.8-2.0). Across all ethnicities, there was a graded increase in CAC incidence and progression with increasing HOMA-IR. When compared with those in the 1st quartile, participants in the 2nd-4th quartiles had 1.2, 1.5, and 1.8 times greater risk of developing CAC. Median annualized CAC score progression was 8, 14, and 17 higher, respectively. However, HOMA-IR was not predictive after adjustment for metabolic syndrome components.

CONCLUSIONS:

HOMA-IR predicts CAC incidence and progression, but not independently of metabolic syndrome.

PMID:
21292863
[PubMed - indexed for MEDLINE]
PMCID:
PMC3041221
Free PMC Article
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