Jongoh Kim1, Young Kwang Chae, Arthur Chernoff. 1. Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, Baylor College of Medicine , Houston, Texas , USA.
Abstract
OBJECTIVE: To examine the role of insulin resistance versus hyperglycemia in the risk for coronary heart disease (CHD) and to explore the interaction of insulin resistance with hyperglycemia. METHODS: This is a cross-sectional study based on the National Health and Nutrition Examination Survey III (NHANES). 4,825 subjects were selected from 9,737 adults aged ³40 years excluding those with fasting <8 hours, type 1 diabetes, pregnancy, or missing data. Insulin resistance was calculated using the HOMA II and then log-transformed (log IR). Odds ratios (OR) of CHD was obtained with multiple logistic regression with reference to non-diabetics with log IR > 1. RESULTS: CHD and type 2 diabetes were present in 9.1 % and 10.5%. Elevated insulin resistance was common; diabetics and non-diabetics with log IR > 1 constituted 6.3% and 12.1% of the population, respectively. ORs for CHD increased as insulin resistance increased in both non-diabetic and diabetics. When log IR > 1, the risk for CHD was not different between diabetics and non-diabetics (OR 1.12, 95% CI; 0.76-1.65). Furthermore, the risk for CHD was higher in non-diabetics with log IR > 1 than in diabetics with log IR1 (OR 0.55, 95% CI; 0.36-0.85). CONCLUSIONS: Insulin resistance was a greater risk for CHD than type 2 diabetes. Non-diabetics can have a higher risk for CHD than diabetics when insulin resistance is elevated. More research is warranted to develop strategies to identify and treat insulin resistance.
OBJECTIVE: To examine the role of insulin resistance versus hyperglycemia in the risk for coronary heart disease (CHD) and to explore the interaction of insulin resistance with hyperglycemia. METHODS: This is a cross-sectional study based on the National Health and Nutrition Examination Survey III (NHANES). 4,825 subjects were selected from 9,737 adults aged ³40 years excluding those with fasting <8 hours, type 1 diabetes, pregnancy, or missing data. Insulin resistance was calculated using the HOMA II and then log-transformed (log IR). Odds ratios (OR) of CHD was obtained with multiple logistic regression with reference to non-diabetics with log IR > 1. RESULTS: CHD and type 2 diabetes were present in 9.1 % and 10.5%. Elevated insulin resistance was common; diabetics and non-diabetics with log IR > 1 constituted 6.3% and 12.1% of the population, respectively. ORs for CHD increased as insulin resistance increased in both non-diabetic and diabetics. When log IR > 1, the risk for CHD was not different between diabetics and non-diabetics (OR 1.12, 95% CI; 0.76-1.65). Furthermore, the risk for CHD was higher in non-diabetics with log IR > 1 than in diabetics with log IR1 (OR 0.55, 95% CI; 0.36-0.85). CONCLUSIONS:Insulin resistance was a greater risk for CHD than type 2 diabetes. Non-diabetics can have a higher risk for CHD than diabetics when insulin resistance is elevated. More research is warranted to develop strategies to identify and treat insulin resistance.
Authors: Sara Pittenger Reid; Chia-Ning Kao; Lauri Pasch; Kanade Shinkai; Marcelle I Cedars; Heather G Huddleston Journal: Fertil Res Pract Date: 2017-05-30