In 1,160 asymptomatic individuals, insulin resistance and central adiposity were positively correlated with elevated coronary artery calcium scores, even with normal fasting serum glucose.
Cross-Sectional (n=1,160)
Are insulin resistance and metabolic risk factors associated with increased coronary artery calcium scores in asymptomatic individuals?
Central/visceral adiposity and traditional risk factors independently predict coronary calcification in asymptomatic individuals, suggesting adiposity is a key determinant of atherosclerosis even in nondiabetic persons.
The insulin resistance syndrome, consisting of resistance to insulin and several metabolic abnormalities, is associated with an increased risk of symptomatic coronary artery disease. Asymptomatic persons with increased coronary calcification have increased coronary plaque and an increased likelihood of future cardiovascular events. Electron-beam computed tomography-derived coronary artery calcium scores, metabolic and anthropometric parameters, and fasting and stimulated concentrations of glucose and insulin were measured in 1160 asymptomatic men and women. Coronary artery calcium scores were positively correlated with glucose, insulin, and homeostasis model assessment (HOMA) insulin resistance. Calcium scores were positively correlated with intra-abdominal adiposity, age, total cholesterol/high density lipoprotein (HDL) ratio, low density lipoprotein, triglycerides, blood pressure, and HOMA beta cell function and inversely correlated with HDL and peripheral fat. These correlations, except for 2-hour glucose, remained significant for all subjects with fasting serum glucose <126 mg/dL or all subjects with fasting serum glucose 110 mg/dL. In a multivariate analysis, age, sex, family history of premature coronary artery disease, intra-abdominal adiposity, low density lipoprotein, and smoking independently predicted calcium scores. Blood pressure, HDL, triglycerides, glucose, insulin, and HOMA insulin resistance or beta cell function were not independently correlated with coronary artery calcium scores. Asymptomatic individuals with insulin resistance have elevated coronary calcium scores. The association between insulin resistance and coronary calcification persists with impaired glucose tolerance and normal fasting serum glucose. Central/visceral adiposity may be a determinant of insulin resistance and atherosclerosis even in asymptomatic nondiabetic persons.
Arad et al. (Sat,) conducted a cross-sectional in Asymptomatic coronary artery disease (n=1,160). Insulin resistance and central adiposity was evaluated on Coronary artery calcium scores. In 1,160 asymptomatic individuals, insulin resistance and central adiposity were positively correlated with elevated coronary artery calcium scores, even with normal fasting serum glucose.