Relationship of Insulin Resistance to Prevalence and Progression of Coronary Artery Calcification beyond Metabolic Syndrome Components

Masahiro Yamazoe, Takashi Hisamatsu, Katsuyuki Miura, Sayaka Kadowaki, Maryam Zaid, Aya Kadota, Sayuki Torii, Itsuko Miyazawa, Akira Fujiyoshi, Hisatomi Arima, Akira Sekikawa, Hiroshi Maegawa, Minoru Horie, Hirotsugu Ueshima

Research output: Contribution to journalArticlepeer-review

19 Citations (Scopus)

Abstract

Objective - The association between insulin resistance (IR) and coronary artery calcification (CAC) has been uncertain after adjustment for metabolic syndrome components. We aimed to evaluate whether IR is associated with CAC prevalence or progression independently of metabolic syndrome components. Approach and Results - We conducted a population-based study in a random sample of Japanese men aged 40 to 79 years and determined IR using the homeostasis model assessment of insulin resistance (HOMA-IR). The associations of HOMA-IR and other diabetic parameters per 1-SD increase with CAC prevalence and progression were evaluated using multivariable logistic regression. Of 1006 total participants at baseline (mean age, 64±10 years), CAC prevalence was observed in 646 (64.2%), and of 789 participants at follow-up (mean duration, 4.9±1.3 years), CAC progression was observed in 365 (46.3%). After adjustment for covariates including metabolic syndrome components, higher HOMA-IR was independently associated with CAC prevalence (adjusted odds ratio 1.34, 95% confidence interval 1.10-1.63; P=0.003) and progression (odds ratio 1.32, 95% confidence interval 1.09-1.60; P=0.004). In participants without diabetes mellitus, positive associations were similarly observed (prevalence: odds ratio 1.29, 95% confidence interval 1.04-1.60; P=0.022; and progression: odds ratio 1.25, 95% confidence interval 1.01-1.55; P=0.042), whereas glucose and hemoglobin A1c were not associated with CAC prevalence and progression. Conclusions - Higher IR was associated with CAC prevalence and progression independently of metabolic syndrome components in Japanese men and also in those without diabetes mellitus. Among diabetic measures, IR and fasting insulin, but not glucose and hemoglobin A1c, predicted CAC progression in men without diabetes mellitus.

Original languageEnglish
Pages (from-to)1703-1708
Number of pages6
JournalArteriosclerosis, Thrombosis, and Vascular Biology
Volume36
Issue number8
DOIs
Publication statusPublished - Aug 1 2016
Externally publishedYes

Keywords

  • atherosclerosis
  • coronary artery calcification
  • epidemiology
  • insulin resistance
  • metabolic syndrome

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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