Key result
HOMA-IR links to increased C-IMT in men, while acute insulin response correlates inversely in women.
Why the study?
Relationships between carotid intima-media thickness and β cell function and insulin resistance in patients with type 2 diabetes have not been fully elucidated.
Cross-Sectional (n=490)
No
Effect estimate: β 0.106 for HOMA-IR in men; β -0.083 for AIR in women
p-value: p=<0.001
In patients with type 2 diabetes, early insulin response is independently associated with carotid intima-media thickness in women, whereas insulin resistance is positively correlated with it in men, suggesting gender-specific mechanisms in diabetic atherosclerosis.
Hypothesis-generating for gender-specific insulin effects on atherosclerosis in diabetes; longitudinal studies needed before clinical consideration.
Objective The relationships between carotid intima-media thickness (C-IMT) and β cell function and insulin resistance in patients with type 2 diabetes (T2D) have not been fully elucidated. This study is to investigate whether impaired glucose metabolism is etiologically associated with C-IMT in patients with T2D. Methods The study group consisted of 490 (284 men, 206 women) participants. Venous blood specimens were obtained from all subjects for biochemical profiles after an >8-h overnight fast. C-IMT was measured as the distance between the luminal-intimal leading edge (I-line) and the medial-adventitial leading edge (M-line) on the far wall. Insulin resistance was estimated with the homeostasis model assessment of insulin resistance (HOMA-IR). The acute insulin response to arginine was calculated as the mean of the three plasma insulin levels obtained within 2, 4, and 6 min after the arginine bolus minus the pre-stimulus plasma insulin levels. Results There was a graded increase in C-IMT values according to tertiles of HOMA-IR in men; the values of C-IMT were significantly decreased across the tertiles of acute insulin and C-peptide responses in women. Multivariate analysis revealed that HOMA-IR and age were positively associated with C-IMT among men participants, and acute insulin response and current smoking were the independent determinants of C-IMT in women. Conclusion Early insulin response stimulated by arginine is independently associated with C-IMT in women T2D individuals, whereas insulin resistance is positively correlated with C-IMT in men T2D subjects.
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Lu et al. (2023) conducted a cross-sectional in Type 2 diabetes (n=490). Insulin resistance (HOMA-IR) and acute insulin response (AIR) vs. Lower tertiles of HOMA-IR or AIR was evaluated on Carotid intima-media thickness (C-IMT) (β 0.106 for HOMA-IR in men; β -0.083 for AIR in women, p=<0.001). Insulin resistance (HOMA-IR) was independently and positively associated with carotid intima-media thickness in men (p<0.001), whereas acute insulin response was independently and negatively associated with it in women (p=0.001).
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