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

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 

Supplementary material

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

References

  1. 1.
    Mazzone T, Chait A, Plutzky J (2008) Cardiovascular disease risk in type 2 diabetes mellitus: insights from mechanistic studies. Lancet 371(9626):1800–1809PubMedCentralPubMedCrossRefGoogle Scholar
  2. 2.
    Emerging Risk Factors Collaboration (2010) Diabetes mellitus, fasting blood glucose concentration, and risk of vascular disease: a collaborative meta-analysis of 102 prospective studies. Lancet 375(9733):2215–2222CrossRefGoogle Scholar
  3. 3.
    Gast KB, Tjeerdema N, Stijnen T, Smit JW, Dekkers OM (2012) Insulin resistance and risk of incident cardiovascular events in adults without diabetes: meta-analysis. PLoS One 7(12):e52036PubMedCentralPubMedCrossRefGoogle Scholar
  4. 4.
    Ginsberg HN (2000) Insulin resistance and cardiovascular disease. J Clin Investig 106(4):453–458Google Scholar
  5. 5.
    Purnell JQ, Zinman B, Brunzell JD, DCCT/EDIC Research Group (2013) The effect of excess weight gain with intensive diabetes mellitus treatment on cardiovascular disease risk factors and atherosclerosis in type 1 diabetes mellitus: results from the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications Study (DCCT/EDIC) study. Circulation 127(2):180–187PubMedCrossRefGoogle Scholar

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

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