Key result
Higher HOMA-IR and adipokine levels are linked to increased subclinical carotid and femoral atherosclerosis.
Why the study?
Do insulin resistance and serum adipokine levels correlate with early subclinical atherosclerosis (carotid and femoral intima-media thickness) in prediabetic patients without clinical cardiovascular disease?
Cross-Sectional (n=122)
Investigator-blinded for IMT ultrasound measurements
No
Do insulin resistance and serum adipokine levels correlate with early subclinical atherosclerosis (carotid and femoral intima-media thickness) in prediabetic patients without clinical cardiovascular disease?
In prediabetic patients free of clinical cardiovascular disease, insulin resistance and altered adipokine levels are independently associated with carotid and femoral intima-media thickness after multivariable adjustment, indicating early subclinical vascular changes.
Answers are grounded in this paper and cite their sources.
Supports adipokine and insulin resistance links to subclinical atherosclerosis in prediabetes; hypothesis-generating and requires prospective validation before clinical adoption.
Cardiovascular risk of prediabetes is still subject to controversies. We analyzed the associations between insulin resistance, adipokines and incipient atherosclerosis estimated by intima-media thickness (IMT) in a cross-sectional study on 122 prediabetic subjects without clinical signs of atherosclerotic disease. Homeostasis model assessment of insulin resistance (HOMA-IR, calculated as fasting insulin × fasting plasma glucose / 22.5), adiponectin, leptin, leptin-to-adiponectin ratio, carotid and femoral IMT were evaluated. We also assessed other parameters related to insulin resistance and adipokines (HbA1c, anthropometric and lipid parameters), as they may also influence atherosclerosis. Carotid IMT was correlated to adiponectin and leptin-to-adiponectin ratio (all p < 0.05), but not with HOMA-IR or leptin, while femoral IMT showed no relationship with these factors. After adjusting for leptin, leptin-to-adiponectin ratio, triglycerides, HDL-cholesterol, cholesterol-to-HDL ratio, triglycerides-to-HDL ratio and HbA1c, IMT values became correlated with HOMA-IR. Adjustment for HOMA-IR induced the appearance of new correlations between adipokines and both IMT values. In conclusion, insulin resistance and adipokines seem related to IMT in prediabetic subjects without clinical signs of arterial obstruction.
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Mihai et al. (2014) conducted a cross-sectional in Prediabetes (impaired fasting glycemia and/or impaired glucose tolerance) without clinical signs of atherosclerotic cardiovascular disease (n=122). Insulin resistance (HOMA-IR) and serum adipokines (adiponectin, leptin, leptin-to-adiponectin ratio) was evaluated on Carotid and femoral intima-media thickness (IMT) (p=<0.05). Adiponectin and leptin-to-adiponectin ratio correlated with carotid IMT, while HOMA-IR correlated with carotid and femoral IMT after adjusting for adipokines, lipids, and HbA1c.
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