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.
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Sudhir Kurl, Francesco Zaccardi, Vivian N. Onaemo, Sae Young Jae, Jussi Kauhanen, Kimmo Ronkainen and Jari A. Laukkanen declare that they have no conflict of interest.
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All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008.
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Informed consent was obtained from all patients for being included in the study.
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Kurl, S., Zaccardi, F., Onaemo, V.N. et al. Association between HOMA-IR, fasting insulin and fasting glucose with coronary heart disease mortality in nondiabetic men: a 20-year observational study. Acta Diabetol 52, 183–186 (2015). https://doi.org/10.1007/s00592-014-0615-x
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DOI: https://doi.org/10.1007/s00592-014-0615-x