2026-04-17T01:42:57Zhttps://recercat.cat/oai/request
oai:recercat.cat:10256/243042024-05-21T10:39:22Zcom_2072_452955com_2072_2054col_2072_452960
RECERCAT author Iglesies-Grau, Josep author García Álvarez, Ana author Oliva, Belén author Mendieta, Guiomar author García-Lunar, Inés author Fuster, José J. author Devesa, Ana author Pérez-Herreras, Cristina author Fernández-Ortiz, Antonio author Brugada, Ramon author Ibanez, Borja author Fernandez-Jimenez, Rodrigo author Fuster, Valentin 2024-05-21T10:39:21Z 2024-05-21T10:39:21Z 2023-12-19 http://hdl.handle.net/10256/24304 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 Attribution 4.0 International (CC BY 4.0) https://creativecommons.org/licenses/by/4.0/ info:eu-repo/semantics/openAccess Aterosclerosi Insulinoresistència Atherosclerosis Insulin resistance Diabetis -- Complicacions Diabetes -- Complications Early insulin resistance in normoglycemic low-risk individuals is associated with subclinical atherosclerosis info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion