Clinical correlates of plasma insulin levels over the life course and association with incident type 2 diabetes: the Framingham Heart Study.
Clinical correlates of plasma insulin levels over the life course and association with incident type 2 diabetes: the Framingham Heart Study.
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DOI：
10.1136/bmjdrc-2021-002581
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发表时间：
2022-03
影响因子：
4.1
通讯作者：
Xanthakis V
中科院分区：
文献类型：
--
作者：
Lieb W;de Oliveira CM;Pan S;Echouffo-Tcheugui JB;Weber KS;Vasan RS;Xanthakis V
Insulin is a glucose-lowering hormone that affects carbohydrate, lipid, and protein metabolism. Limited data exist on the correlates of insulin levels over the life course in healthy community-dwelling individuals. Using multilevel modeling of multiple serial observations over 21 years, we assessed the longitudinal correlates of fasting insulin and the cross-sectional correlates of fasting and 2-hour (2h, post 75 g glucose challenge) plasma insulin concentrations in 2140 relatively healthy Framingham Heart Study participants without diabetes (61% women; mean age, 42 years). We used multivariable-adjusted Cox regression to relate glycemic markers (fasting and 2h-insulin, fasting glucose, 2h-glucose, and hemoglobin A1C) to the risk of type 2 diabetes during follow-up. Over the life course, fasting insulin concentrations were inversely associated with age, male sex, and physical activity, whereas waist circumference, the total/high-density lipoprotein (HDL) cholesterol ratio, and blood triglycerides were positively associated with insulin levels (p<0.005 for all). Male sex (inversely related) and the total/HDL cholesterol ratio (positively related) emerged as the most important cross-sectional correlates of 2h-insulin (p<0.005 for all). All markers were associated with higher risk of type 2 diabetes (352 cases, median follow-up 18 years, p<0.001 for all). We observed common and distinct correlates of fasting and 2h-insulin levels. Our findings highlight a potential role of insulin in lipid and lipoprotein metabolism. Furthermore, fasting and 2h-insulin are critical markers of future diabetes risk. Further studies are needed to confirm our findings.
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