Acta Diabetologica

, Volume 52, Issue 1, pp 183–186

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

  • Sudhir Kurl
  • Francesco Zaccardi
  • Vivian N. Onaemo
  • Sae Young Jae
  • Jussi Kauhanen
  • Kimmo Ronkainen
  • Jari A. Laukkanen
Short Communication

DOI: 10.1007/s00592-014-0615-x

Cite this article as:
Kurl, S., Zaccardi, F., Onaemo, V.N. et al. Acta Diabetol (2015) 52: 183. doi:10.1007/s00592-014-0615-x
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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 resistanceCoronary heart diseaseMortalityMenRisk factors

Supplementary material

592_2014_615_MOESM1_ESM.docx (20 kb)
Supplementary material 1 (DOCX 19 kb)

Copyright information

© Springer-Verlag Italia 2014

Authors and Affiliations

  • Sudhir Kurl
    • 1
    • 2
  • Francesco Zaccardi
    • 3
  • Vivian N. Onaemo
    • 1
  • Sae Young Jae
    • 4
  • Jussi Kauhanen
    • 1
  • Kimmo Ronkainen
    • 1
  • Jari A. Laukkanen
    • 1
    • 2
  1. 1.Institute of Public Health, School of Public Health and Clinical NutritionUniversity of Eastern FinlandKuopioFinland
  2. 2.Department of Internal MedicineLapland Central HospitalRovaniemiFinland
  3. 3.Internal Medicine and Diabetes Care Unit, Policlinico Gemelli HospitalCatholic University of the Sacred HeartRomeItaly
  4. 4.Department of Sports Informatics, College of Arts and Physical EducationUniversity of SeoulSeoulSouth Korea