Short Communication

Acta Diabetologica

, Volume 52, Issue 1, pp 183-186

First online:

Association between HOMA-IR, fasting insulin and fasting glucose with coronary heart disease mortality in nondiabetic men: a 20-year observational study

  • Sudhir KurlAffiliated withInstitute of Public Health, School of Public Health and Clinical Nutrition, University of Eastern FinlandDepartment of Internal Medicine, Lapland Central Hospital Email author 
  • , Francesco ZaccardiAffiliated withInternal Medicine and Diabetes Care Unit, Policlinico Gemelli Hospital, Catholic University of the Sacred Heart
  • , Vivian N. OnaemoAffiliated withInstitute of Public Health, School of Public Health and Clinical Nutrition, University of Eastern Finland
  • , Sae Young JaeAffiliated withDepartment of Sports Informatics, College of Arts and Physical Education, University of Seoul
  • , Jussi KauhanenAffiliated withInstitute of Public Health, School of Public Health and Clinical Nutrition, University of Eastern Finland
  • , Kimmo RonkainenAffiliated withInstitute of Public Health, School of Public Health and Clinical Nutrition, University of Eastern Finland
  • , Jari A. LaukkanenAffiliated withInstitute of Public Health, School of Public Health and Clinical Nutrition, University of Eastern FinlandDepartment of Internal Medicine, Lapland Central Hospital

Rent the article at a discount

Rent now

* Final gross prices may vary according to local VAT.

Get Access

Abstract

Whether glucose and insulin are differently associated with the risk of coronary heart disease (CHD) mortality is unclear. We aimed to estimate the association between insulin resistance (estimated by the homeostasis model assessment for insulin resistance, HOMA-IR), fasting serum insulin (FI) and fasting plasma glucose (FPG) with incident CHD mortality in a prospective study including middle-aged nondiabetic Finnish men. During an average follow-up of 20 years, 273 (11 %) CHD deaths occurred. In a multivariable Cox regression analysis adjusted for age, body mass index, systolic blood pressure, serum LDL-cholesterol, cigarette smoking, history of CHD, alcohol consumption, blood leukocytes and plasma fibrinogen, the hazard ratios (HRs) for CHD mortality comparing top versus bottom quartiles were as follows: 1.69 (95 % CI: 1.15–2.48; p = 0.008) for HOMA-IR; 1.59 (1.09–2.32; p = 0.016) for FI; and 1.26 (0.90–1.76; p = 0.173) for FPG. These findings suggest that IR and FI, but not FPG, are independent risk factors for CHD mortality. Further studies could help clarify these results in terms of screening and risk stratification, causality of the associations, and therapeutical implications.

Keywords

Insulin resistance Coronary heart disease Mortality Men Risk factors