Masahiro Yamazoe1, Takashi Hisamatsu2, Katsuyuki Miura2, Sayaka Kadowaki2, Maryam Zaid2, Aya Kadota2, Sayuki Torii2, Itsuko Miyazawa2, Akira Fujiyoshi2, Hisatomi Arima2, Akira Sekikawa2, Hiroshi Maegawa2, Minoru Horie2, Hirotsugu Ueshima2. 1. From the Department of Cardiology, Tokyo Medical and Dental University, Tokyo, Japan (M.Y.); Center for Epidemiologic Research in Asia (M.Y., K.M., A.K., H.A., H.U.), Department of Public Health (M.Y., T.H., K.M., S.K., M.Z., A.K., S.T., A.F., H.A., H.U.), Department of Cardiovascular and Respiratory Medicine (T.H., S.T., M.H.), Division of Endocrinology and Metabolism, Department of Medicine (I.M., H.M.), Shiga University of Medical Science, Otsu, Japan; Department of Environmental Medicine and Public Health, Faculty of Medicine, Shimane University, Izumo, Japan (T.H.); Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, Fukuoka, Japan (H.A.); and Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, PA (A.S.). masahiro.yamazoe@gmail.com. 2. From the Department of Cardiology, Tokyo Medical and Dental University, Tokyo, Japan (M.Y.); Center for Epidemiologic Research in Asia (M.Y., K.M., A.K., H.A., H.U.), Department of Public Health (M.Y., T.H., K.M., S.K., M.Z., A.K., S.T., A.F., H.A., H.U.), Department of Cardiovascular and Respiratory Medicine (T.H., S.T., M.H.), Division of Endocrinology and Metabolism, Department of Medicine (I.M., H.M.), Shiga University of Medical Science, Otsu, Japan; Department of Environmental Medicine and Public Health, Faculty of Medicine, Shimane University, Izumo, Japan (T.H.); Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, Fukuoka, Japan (H.A.); and Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, PA (A.S.).
Abstract
OBJECTIVE: The association between insulin resistance (IR) and coronary artery calcification (CAC) has been uncertain after adjustment for metabolic syndrome components. We aimed to evaluate whether IR is associated with CAC prevalence or progression independently of metabolic syndrome components. APPROACH AND RESULTS: We conducted a population-based study in a random sample of Japanese men aged 40 to 79 years and determined IR using the homeostasis model assessment of insulin resistance (HOMA-IR). The associations of HOMA-IR and other diabetic parameters per 1-SD increase with CAC prevalence and progression were evaluated using multivariable logistic regression. Of 1006 total participants at baseline (mean age, 64±10 years), CAC prevalence was observed in 646 (64.2%), and of 789 participants at follow-up (mean duration, 4.9±1.3 years), CAC progression was observed in 365 (46.3%). After adjustment for covariates including metabolic syndrome components, higher HOMA-IR was independently associated with CAC prevalence (adjusted odds ratio 1.34, 95% confidence interval 1.10-1.63; P=0.003) and progression (odds ratio 1.32, 95% confidence interval 1.09-1.60; P=0.004). In participants without diabetes mellitus, positive associations were similarly observed (prevalence: odds ratio 1.29, 95% confidence interval 1.04-1.60; P=0.022; and progression: odds ratio 1.25, 95% confidence interval 1.01-1.55; P=0.042), whereas glucose and hemoglobin A1c were not associated with CAC prevalence and progression. CONCLUSIONS: Higher IR was associated with CAC prevalence and progression independently of metabolic syndrome components in Japanese men and also in those without diabetes mellitus. Among diabetic measures, IR and fasting insulin, but not glucose and hemoglobin A1c, predicted CAC progression in men without diabetes mellitus.
OBJECTIVE: The association between insulin resistance (IR) and coronary artery calcification (CAC) has been uncertain after adjustment for metabolic syndrome components. We aimed to evaluate whether IR is associated with CAC prevalence or progression independently of metabolic syndrome components. APPROACH AND RESULTS: We conducted a population-based study in a random sample of Japanese men aged 40 to 79 years and determined IR using the homeostasis model assessment of insulin resistance (HOMA-IR). The associations of HOMA-IR and other diabetic parameters per 1-SD increase with CAC prevalence and progression were evaluated using multivariable logistic regression. Of 1006 total participants at baseline (mean age, 64±10 years), CAC prevalence was observed in 646 (64.2%), and of 789 participants at follow-up (mean duration, 4.9±1.3 years), CAC progression was observed in 365 (46.3%). After adjustment for covariates including metabolic syndrome components, higher HOMA-IR was independently associated with CAC prevalence (adjusted odds ratio 1.34, 95% confidence interval 1.10-1.63; P=0.003) and progression (odds ratio 1.32, 95% confidence interval 1.09-1.60; P=0.004). In participants without diabetes mellitus, positive associations were similarly observed (prevalence: odds ratio 1.29, 95% confidence interval 1.04-1.60; P=0.022; and progression: odds ratio 1.25, 95% confidence interval 1.01-1.55; P=0.042), whereas glucose and hemoglobin A1c were not associated with CAC prevalence and progression. CONCLUSIONS: Higher IR was associated with CAC prevalence and progression independently of metabolic syndrome components in Japanese men and also in those without diabetes mellitus. Among diabetic measures, IR and fasting insulin, but not glucose and hemoglobin A1c, predicted CAC progression in men without diabetes mellitus.
Authors: Gerald M Reaven; Joshua W Knowles; David Leonard; Carolyn E Barlow; Benjamin L Willis; William L Haskell; David J Maron Journal: J Clin Lipidol Date: 2017-06-06 Impact factor: 4.766
Authors: Min Kyung Kim; Chul Woo Ahn; Shinae Kang; Ji Sun Nam; Kyung Rae Kim; Jong Suk Park Journal: Cardiovasc Diabetol Date: 2017-08-23 Impact factor: 9.951