Article: HOMA-estimated insulin resistance is an independent predictor of cardiovascular disease in type 2 diabetic subjects: prospective data from the Verona Diabetes Complications Study.
2002 Volume 25, Issue 7, Page(s) 1135–1141
Abstract: Objective: To evaluate whether homeostasis model assessment-estimated insulin resistance (HOMA-IR) is an independent predictor of cardiovascular disease (CVD) in type 2 diabetes.: Research design and methods: Conventional CVD risk factors (sex, age, ... ...
| Abstract | Objective: To evaluate whether homeostasis model assessment-estimated insulin resistance (HOMA-IR) is an independent predictor of cardiovascular disease (CVD) in type 2 diabetes. Research design and methods: Conventional CVD risk factors (sex, age, smoking, plasma lipids, blood pressure, and metabolic control) and insulin resistance (estimated by HOMA) were evaluated at baseline in 1,326 patients with type 2 diabetes examined within the Verona Diabetes Complications Study. At baseline and after a mean follow-up of 4.5 years, CVD was assessed by medical history, physical examination, electrocardiography, and echo-Doppler of carotid and lower limb arteries. Death certificates and medical records of subjects who died during the follow-up were carefully scrutinized to identify cardiovascular deaths. In statistical analyses, CVD was an aggregate end point including both fatal and nonfatal coronary, cerebrovascular, and peripheral vascular disease as well as ischemic electrocardiographic abnormalities and vascular lesions identified by echo-Doppler. Results: At baseline, 441 subjects were coded positive for CVD (prevalent cases). Incident cases numbered 126. Multiple logistic regression analyses showed that, along with sex, age, smoking, HDL/total cholesterol ratio, and hypertension, HOMA-IR was an independent predictor of both prevalent and incident CVD. A 1-unit increase in (log)HOMA-IR value was associated with an odds ratio for prevalent CVD at baseline of 1.31 (95% CI 1.10-1.56, P = 0.002) and for incident CVD during follow-up of 1.56 (95% CI 1.14-2.12, P < 0.001). Conclusions: HOMA-IR is an independent predictor of CVD in type 2 diabetes. The improvement of insulin resistance might have beneficial effects not only on glucose control but also on CVD in patients with type 2 diabetes. |
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| MeSH term(s) | Age of Onset ; Blood Glucose/metabolism ; Blood Pressure ; Body Mass Index ; Cardiovascular Diseases/epidemiology ; Cholesterol/blood ; Diabetes Mellitus, Type 2/physiopathology ; Diabetic Angiopathies/physiopathology ; Female ; Homeostasis ; Humans ; Hypertension/epidemiology ; Insulin Resistance ; Lipids/blood ; Lipoproteins/blood ; Male ; Middle Aged ; Predictive Value of Tests ; Risk Factors ; Smoking ; Triglycerides/blood |
| Chemical Substances | Blood Glucose ; Lipids ; Lipoproteins ; Triglycerides ; Cholesterol (97C5T2UQ7J) |
| Language | English |
| Publishing date | 2002-05-24 |
| Publishing country | United States |
| Document type | Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov't |
| ZDB-ID | 441231-x |
| ISSN | 1935-5548 ; 0149-5992 |
| ISSN (online) | 1935-5548 |
| ISSN | 0149-5992 |
| DOI | 10.2337/diacare.25.7.1135 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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