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Nutr Metab Cardiovasc Dis. 2018 Jul;28(7):716-721. doi: 10.1016/j.numecd.2018.02.016. Epub 2018 Mar 2.

Fasting and post-glucose load measures of insulin resistance and risk of incident atrial fibrillation: The Cardiovascular Health Study.

Author information

1
Division of Cardiology, University of Southern California Keck School of Medicine, Los Angeles, CA, USA. Electronic address: parveeng@med.usc.edu.
2
Department of Biostatistics, University of Washington, Seattle, WA, USA.
3
Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA.
4
Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA; Department of Medicine, Albert Einstein College of Medicine, Bronx, NY, USA.
5
Department of Epidemiology, University of Washington, Seattle, WA, USA.
6
Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA.

Abstract

BACKGROUND AND AIMS:

Existing literature in individuals without diabetes has not demonstrated a relationship between IR and incident AF; however, data are limited and only fasting glucose measures of IR were assessed. We evaluated the relationship of both fasting and post-glucose load IR measures with the development of atrial fibrillation in nondiabetic older adults.

METHODS AND RESULTS:

Among Cardiovascular Health Study participants, a population-based cohort of 5888 adults aged 65 years or older enrolled in two waves (1989-1990 and 1992-1993), those without prevalent AF or diabetes and with IR measures at baseline were followed for the development of AF, identified by follow-up visit electrocardiograms, hospital discharge diagnosis coding, or Medicare claims data, through 2014. Fasting IR was determined by the homeostatic model of insulin resistance (HOMA-IR) and post-glucose load IR was determined by the Gutt index. Cox proportional hazards models were used to determine the association of IR with risk of AF. Analyses included 3601 participants (41% men) with a mean age of 73 years. Over a median follow-up of 12.3 years, 1443 (40%) developed AF. After multivariate adjustment, neither HOMA-IR nor the Gutt index was associated with risk of developing AF [hazard ratios (95% confidence intervals): 0.96 (0.90, 1.03) for 1-SD increase in HOMA-IR and 1.03 (0.97, 1.10) for 1-SD decrease in the Gutt index].

CONCLUSIONS:

We found no evidence of an association between either fasting or post-glucose load IR measures and incident AF.

KEYWORDS:

Atrial Fibrillation; Epidemiology; Insulin resistance

PMID:
29615289
PMCID:
PMC6151262
DOI:
10.1016/j.numecd.2018.02.016
[Indexed for MEDLINE]
Free PMC Article

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