Insulin resistance and incident heart failure the ARIC study (Atherosclerosis Risk in Communities).
Insulin resistance and incident heart failure the ARIC study (Atherosclerosis Risk in Communities).
复制标题
DOI：
10.1016/j.jchf.2013.07.006
复制
发表时间：
2013-12
期刊：
影响因子：
--
通讯作者：
Solomon SD
中科院分区：
文献类型：
--
作者：
Vardeny O;Gupta DK;Claggett B;Burke S;Shah A;Loehr L;Rasmussen-Torvik L;Selvin E;Chang PP;Aguilar D;Solomon SD
本研究的目的是评估胰岛素抵抗和心力衰竭（HF）事件之间的关系，在社区为基础的队列。糖尿病可增加HF的风险，但胰岛素抵抗与非糖尿病患者HF之间的关系尚不清楚。我们前瞻性分析了ARIC（社区动脉粥样硬化风险）研究中基线（1987 - 1989年）无糖尿病、无心衰或无心肌梗死病史的12,606例受试者。我们使用胰岛素抵抗的稳态模型评估（HOMA-IR）方程评估了胰岛素抵抗与HF事件之间的关系，并调整了年龄、性别、种族、体重指数、吸烟、高血压、中心和中期心肌梗死。我们测试了年龄、性别、肥胖和种族的相互作用。胰岛素抵抗的受试者定义为HOMA-IR ≥2.5（n = 4，810，39%），与无胰岛素抵抗的受试者相比，年龄较大，更可能是女性，非洲裔美国人，高血压，体重指数较高。在中位数为20.6年的随访期间，有1，455例HF事件。调整后，由该阈值定义的胰岛素抵抗与HF事件风险增加无显著相关性（风险比：1.08，95%置信区间：0.95 - 1.23）。然而，当连续分析时，这种关系是非线性的，这表明风险增加，并且在HOMA-IR为1.0至2.0之间与HF事件显著相关，校正基线协变量;然而，在校正模型中，超过2.5的值与额外的风险增加无关。在一个社区队列中，胰岛素抵抗（定义为HOMA-IR水平低于以前认为的水平）与HF风险增加相关。
This study was designed to assess the relationship between insulin resistance and incident heart failure (HF) in a community-based cohort. Diabetes mellitus increases the risk for HF, but the association between insulin resistance and HF in individuals without diabetes is unclear. We prospectively analyzed 12,606 participants without diabetes mellitus, prevalent HF, or history of myocardial infarction at baseline (1987 to 1989) from the ARIC (Atherosclerosis Risk in Communities) study. We assessed the relationship between insulin resistance and incident HF using the homeostatic model assessment of insulin resistance (HOMA-IR) equation, adjusting for age, sex, race, body mass index, smoking, hypertension, center, and interim myocardial infarction. We tested for interactions by age, sex, obesity, and race. Participants with insulin resistance, defined as HOMA-IR ≥2.5 (n = 4,810, 39%), were older, more likely female, African American, hypertensive, and had a higher body mass index as compared with those without insulin resistance. There were 1,455 incident HF cases during a median of 20.6 years of follow-up. Insulin resistance defined by this threshold was not significantly associated with an increased risk for incident HF after adjustment (hazard ratio: 1.08, 95% confidence interval: 0.95 to 1.23). However, when analyzed continuously, this relationship was nonlinear, which indicated that risk increased, and was significantly associated with incident HF between HOMA-IR of 1.0 to 2.0, adjusting for baseline covariates; however, values over 2.5 were not associated with additional increased risk in adjusted models. In a community cohort, insulin resistance, defined by lower levels of HOMA-IR than previously considered, was associated with an increased risk for HF.
登录
查看更多内容
影响因子：
15.9
作者：
DEFRONZO, RA;COOKE, CR;DAVIS, PJ
通讯作者：
DAVIS, PJ
影响因子：
9.7
作者：
Loehr, Laura R.;Rosamond, Wayne D.;Heiss, Gerardo
通讯作者：
Heiss, Gerardo
影响因子：
3.2
作者：
Sartori, M;Ceolotto, G;Semplicini, A
通讯作者：
Semplicini, A
影响因子：
15.9
作者：
ANDERSON, EA;HOFFMAN, RP;MARK, AL
通讯作者：
MARK, AL
影响因子：
24
作者：
Bahrami, Hossein;Bluemke, David A.;Lima, Joao A. C.
通讯作者：
Lima, Joao A. C.