April 1, 2000Diabetic Medicine
Relation between insulin resistance and carotid intima‐media thickness and stenosis in non‐diabetic subjects. Results from a cross‐sectional study in Malmö, Sweden
Why the study?
Is insulin resistance associated with increased carotid intima-media thickness and stenosis in non-diabetic subjects?
Population
4,816 non-diabetic subjects free from symptomatic cardiovascular disease, born 1926-1945, 40% men, from…
Comparison
Insulin resistance and insulin resistance syndrome vs Subjects without insulin resistance or insulin…
Design
Cross-sectional
Authors
Discussion
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Implication
IMT elevation in insulin resistance syndrome is not independent of co-factors; leaves open any direct atherogenic role in non-diabetics.
Key Points
- To assess whether an association exists between insulin resistance and carotid artery intima-media thickness and stenosis in non-diabetic subjects without symptomatic cardiovascular disease.
- Conducted a cross-sectional population-based study in Malmö, Sweden, among N=4,816 non-diabetic subjects (40% men) born between 1926 and 1945.
- Identified insulin resistance using the homeostasis model assessment (HOMA >75th percentile) and defined insulin resistance syndrome via European Group for the Study of Insulin Resistance (EGIR) criteria.
- Measured common carotid artery intima-media thickness (IMT) and carotid stenosis (>15%) using B-mode ultrasonography.
- Subjects with the insulin resistance syndrome (12.7% prevalence) had significantly higher age- and sex-adjusted common carotid IMT than controls (0.812 mm vs. 0.778 mm, P < 0.001) and higher stenosis prevalence (22.9% vs. 19.2%, P = 0.040).
- Insulin resistance per se was associated with increased IMT after age and sex adjustment (0.780 mm vs. 0.754 mm, P < 0.001), but this association disappeared after adjusting for other risk components of the syndrome, especially hypertension.
Structured PICO
Is insulin resistance associated with increased carotid intima-media thickness and stenosis in non-diabetic subjects?
P
Population
4,816 non-diabetic subjects free from symptomatic cardiovascular disease, born 1926-1945, 40% men, from Malmö, Sweden.
I
Intervention
Insulin resistance (assessed by HOMA >75th percentile) and insulin resistance syndrome (EGIR criteria)
C
Comparator
Subjects without insulin resistance or insulin resistance syndrome
O
Outcome
Common carotid artery intima-media thickness (IMT) and carotid stenosis (> 15%) measured by B-mode ultrasonographysurrogate
The association between insulin resistance and carotid atherosclerosis in non-diabetic subjects is primarily driven by its covariance with established risk factors, particularly hypertension.
Cite This Study
Hedblad et al. (2000) studied this question.