Early insulin resistance in normoglycemic low-risk individuals is associated with subclinical atherosclerosis

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...

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Autores: Iglesies-Grau, Josep, García Álvarez, Ana, Oliva, Belén, Mendieta, Guiomar, García-Lunar, Inés, Fuster, José J., Devesa, Ana, Pérez-Herreras, Cristina, Fernández-Ortiz, Antonio, Brugada, Ramon, Ibanez, Borja, Fernandez-Jimenez, Rodrigo, Fuster, Valentin
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2023
País:España
Institución:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repositorio:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:10256/24304
Acceso en línea:http://hdl.handle.net/10256/24304
Access Level:acceso abierto
Palabra clave:Aterosclerosi
Insulinoresistència
Atherosclerosis
Insulin resistance
Diabetis -- Complicacions
Diabetes -- Complications
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network_acronym_str ES
network_name_str España
repository_id_str
spelling Early insulin resistance in normoglycemic low-risk individuals is associated with subclinical atherosclerosisIglesies-Grau, JosepGarcía Álvarez, AnaOliva, BelénMendieta, GuiomarGarcía-Lunar, InésFuster, José J.Devesa, AnaPérez-Herreras, CristinaFernández-Ortiz, AntonioBrugada, RamonIbanez, BorjaFernandez-Jimenez, RodrigoFuster, ValentinAterosclerosiInsulinoresistènciaAtherosclerosisInsulin resistanceDiabetis -- ComplicacionsDiabetes -- ComplicationsBackground 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 practiceBioMed Central2023info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttp://hdl.handle.net/10256/24304http://hdl.handle.net/10256/24304Cardiovascular Diabetology, 2023, vol. 22, art.núm. 350Articles publicats (D-CM)Iglesies-Grau, Josep García Álvarez, Ana Oliva, Belén Mendieta, Guiomar García-Lunar, Inés Fuster, José J. Devesa, Ana Pérez-Herreras, Cristina Fernández-Ortiz, Antonio Brugada, Ramon Ibanez. Borja Fernandez-Jimenez, Rodrigo Fuster, Valentin 2023 Early insulin resistance in normoglycemic low-risk individuals is associated with subclinical atherosclerosis Cardiovascular Diabetology 22 art.núm. 350reponame:Recercat. Dipósit de la Recerca de Catalunyainstname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)Inglésinfo:eu-repo/semantics/altIdentifier/doi/10.1186/s12933-023-02090-1info:eu-repo/semantics/altIdentifier/eissn/1475-2840Attribution 4.0 International (CC BY 4.0)https://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:recercat.cat:10256/243042026-05-29T05:05:01Z
dc.title.none.fl_str_mv Early insulin resistance in normoglycemic low-risk individuals is associated with subclinical atherosclerosis
title Early insulin resistance in normoglycemic low-risk individuals is associated with subclinical atherosclerosis
spellingShingle Early insulin resistance in normoglycemic low-risk individuals is associated with subclinical atherosclerosis
Iglesies-Grau, Josep
Aterosclerosi
Insulinoresistència
Atherosclerosis
Insulin resistance
Diabetis -- Complicacions
Diabetes -- Complications
title_short Early insulin resistance in normoglycemic low-risk individuals is associated with subclinical atherosclerosis
title_full Early insulin resistance in normoglycemic low-risk individuals is associated with subclinical atherosclerosis
title_fullStr Early insulin resistance in normoglycemic low-risk individuals is associated with subclinical atherosclerosis
title_full_unstemmed Early insulin resistance in normoglycemic low-risk individuals is associated with subclinical atherosclerosis
title_sort Early insulin resistance in normoglycemic low-risk individuals is associated with subclinical atherosclerosis
dc.creator.none.fl_str_mv Iglesies-Grau, Josep
García Álvarez, Ana
Oliva, Belén
Mendieta, Guiomar
García-Lunar, Inés
Fuster, José J.
Devesa, Ana
Pérez-Herreras, Cristina
Fernández-Ortiz, Antonio
Brugada, Ramon
Ibanez, Borja
Fernandez-Jimenez, Rodrigo
Fuster, Valentin
author Iglesies-Grau, Josep
author_facet Iglesies-Grau, Josep
García Álvarez, Ana
Oliva, Belén
Mendieta, Guiomar
García-Lunar, Inés
Fuster, José J.
Devesa, Ana
Pérez-Herreras, Cristina
Fernández-Ortiz, Antonio
Brugada, Ramon
Ibanez, Borja
Fernandez-Jimenez, Rodrigo
Fuster, Valentin
author_role author
author2 García Álvarez, Ana
Oliva, Belén
Mendieta, Guiomar
García-Lunar, Inés
Fuster, José J.
Devesa, Ana
Pérez-Herreras, Cristina
Fernández-Ortiz, Antonio
Brugada, Ramon
Ibanez, Borja
Fernandez-Jimenez, Rodrigo
Fuster, Valentin
author2_role author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Aterosclerosi
Insulinoresistència
Atherosclerosis
Insulin resistance
Diabetis -- Complicacions
Diabetes -- Complications
topic Aterosclerosi
Insulinoresistència
Atherosclerosis
Insulin resistance
Diabetis -- Complicacions
Diabetes -- Complications
description 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
publishDate 2023
dc.date.none.fl_str_mv 2023
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/10256/24304
http://hdl.handle.net/10256/24304
url http://hdl.handle.net/10256/24304
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv info:eu-repo/semantics/altIdentifier/doi/10.1186/s12933-023-02090-1
info:eu-repo/semantics/altIdentifier/eissn/1475-2840
dc.rights.none.fl_str_mv Attribution 4.0 International (CC BY 4.0)
https://creativecommons.org/licenses/by/4.0/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv Attribution 4.0 International (CC BY 4.0)
https://creativecommons.org/licenses/by/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv BioMed Central
publisher.none.fl_str_mv BioMed Central
dc.source.none.fl_str_mv Cardiovascular Diabetology, 2023, vol. 22, art.núm. 350
Articles publicats (D-CM)
Iglesies-Grau, Josep García Álvarez, Ana Oliva, Belén Mendieta, Guiomar García-Lunar, Inés Fuster, José J. Devesa, Ana Pérez-Herreras, Cristina Fernández-Ortiz, Antonio Brugada, Ramon Ibanez. Borja Fernandez-Jimenez, Rodrigo Fuster, Valentin 2023 Early insulin resistance in normoglycemic low-risk individuals is associated with subclinical atherosclerosis Cardiovascular Diabetology 22 art.núm. 350
reponame:Recercat. Dipósit de la Recerca de Catalunya
instname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
instname_str Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
reponame_str Recercat. Dipósit de la Recerca de Catalunya
collection Recercat. Dipósit de la Recerca de Catalunya
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15.811543

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