The Relationship Between Insulin Resistance and Incidence and Progression of Coronary Artery Calcification The Multi-Ethnic Study of Atherosclerosis (MESA)
The Relationship Between Insulin Resistance and Incidence and Progression of Coronary Artery Calcification The Multi-Ethnic Study of Atherosclerosis (MESA)
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DOI：
10.2337/dc10-1681
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发表时间：
2011-03-01
期刊：
影响因子：
16.2
通讯作者：
Nasir, Khurram
中科院分区：
文献类型：
--
作者：
Blaha, Michael J.;DeFilippis, Andrew P.;Nasir, Khurram
目的 - 我们试图确定胰岛素抵抗是否可以预测冠状动脉钙化 (CAC) 的发生和进展。 研究设计和方法 - 我们研究了来自动脉粥样硬化多种族研究 (MESA) 的 5,464 名未接受降血糖治疗的参与者。每个人都有胰岛素抵抗的基线稳态模型评估 (HOMA-IR) 以及基线和随访 CAC 评分。事件CAC被定义为新检测到的CAC；进展定义为随访时 CAC 体积评分的进展。结果 - HOMA-IR 中位数为 1.2 (0.8-2.0)。在所有种族中，随着 HOMA-IR 的增加，CAC 的发病率和进展呈分级增加。与第一四分位数的参与者相比，第二至第四四分位数的参与者患 CAC 的风险分别高出 1.2、1.5 和 1.8 倍。年化 CAC 评分进展中位数分别高出 8、14 和 17。然而，在调整代谢综合征的组成部分后，HOMA-IR 并不能预测 CAC 的发生率和进展，但不能独立于代谢综合征。
OBJECTIVE-We sought to determine whether insulin resistance predicts the incidence and progression of coronary artery calcification (CAC).RESEARCH DESIGN AND METHODS-We studied 5,464 participants not on hypoglycemic therapy from the Multi-Ethnic Study of Atherosclerosis (MESA). Each had baseline homeostasis model assessment of insulin resistance (HOMA-IR) and baseline and follow-up CAC scores. Incident CAC was defined as newly detectable CAC; progression was defined as advancing CAC volume score at follow-up.RESULTS-Median HOMA-IR was 1.2 (0.8-2.0). Across all ethnicities, there was a graded increase in CAC incidence and progression with increasing HOMA-IR. When compared with those in the 1st quartile, participants in the 2nd-4th quartiles had 1.2, 1.5, and 1.8 times greater risk of developing CAC. Median annualized CAC score progression was 8, 14, and 17 higher, respectively. However, HOMA-IR was not predictive after adjustment for metabolic syndrome components.CONCLUSIONS-HOMA-IR predicts CAC incidence and progression, but not independently of metabolic syndrome.