2026-04-13T03:58:43Zhttps://recercat.cat/oai/request

oai:recercat.cat:10256/243042024-05-21T10:39:22Zcom_2072_452955com_2072_2054col_2072_452960

Early insulin resistance in normoglycemic low-risk individuals is associated with subclinical atherosclerosis Iglesies-Grau, Josep García Álvarez, Ana Oliva, Belén Mendieta, Guiomar García-Lunar, Inés Fuster, José J. Devesa, Ana Pérez-Herreras, Cristina Fernández-Ortiz, Antonio Brugada, Ramon Ibanez, Borja Fernandez-Jimenez, Rodrigo Fuster, Valentin Aterosclerosi Insulinoresistència Atherosclerosis Insulin resistance Diabetis -- Complicacions Diabetes -- Complications 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 2024-05-21T10:39:21Z 2024-05-21T10:39:21Z 2024-05-21T10:39:21Z 2023-12-19 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion http://hdl.handle.net/10256/24304 info:eu-repo/semantics/altIdentifier/doi/10.1186/s12933-023-02090-1 info:eu-repo/semantics/altIdentifier/eissn/1475-2840 Attribution 4.0 International (CC BY 4.0) https://creativecommons.org/licenses/by/4.0/ info:eu-repo/semantics/openAccess BioMed Central Cardiovascular Diabetology, 2023, vol. 22, art.núm. 350 Articles publicats (D-CM) Iglesies-Grau, Josep García Álvarez, Ana Oliva, Belén Mendieta, Guiomar García-Lunar, Inés Fuster, José J. Devesa, Ana Pérez-Herreras, Cristina Fernández-Ortiz, Antonio Brugada, Ramon Ibanez. Borja Fernandez-Jimenez, Rodrigo Fuster, Valentin 2023 Early insulin resistance in normoglycemic low-risk individuals is associated with subclinical atherosclerosis Cardiovascular Diabetology 22 art.núm. 350