Key result
In healthy subjects, increasing fasting insulin levels were significantly associated with a greater increase in stress-related arterial stiffness in women (r=0.37, p=0.023), a response not observed in men.
Why the study?
Does insulin resistance differentially affect heart rate variability and arterial stiffness responses to a physiologic stressor in healthy women compared to men?
Cross-Sectional (n=48)
No
Does insulin resistance differentially affect heart rate variability and arterial stiffness responses to a physiologic stressor in healthy women compared to men?
Effect estimate: r=0.37
p-value: p=0.023
Healthy women exhibit an unfavorable cardiovascular physiological response (increased arterial stiffness) to a physiologic stressor with increasing insulin resistance, a pattern not seen in men, highlighting early sex-specific cardiovascular risk mechanisms.
Suggests early sex-specific vascular vulnerability to insulin resistance; hypothesis-generating and should not yet change practice.
Diabetes confers greater cardiovascular risk to women than to men. Whether insulin-resistance-mediated risk extends to the healthy population is unknown. Measures of insulin resistance (fasting insulin, homeostatic model assessment, hemoglobin A1c, quantitative insulin sensitivity check index, glucose) were determined in 48 (56% female) healthy subjects. Heart rate variability (HRV) was calculated by spectral power analysis and arterial stiffness was determined using noninvasive applanation tonometry. Both were measured at baseline and in response to angiotensin II infusion. In women, there was a non-statistically significant trend towards increasing insulin resistance being associated with an overall unfavourable HRV response and increased arterial stiffness to the stressor, while men demonstrated the opposite response. Significant differences in the associations between insulin resistance and cardiovascular physiological profile exist between healthy women and men. Further studies investigating the sex differences in the pathophysiology of insulin resistance in cardiovascular disease are warranted.
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Rannelli et al. (2016) conducted a cross-sectional in Healthy (n=48). Insulin resistance (during Angiotensin II physiological stressor) vs. Men (sex-based comparison) was evaluated on Association between fasting insulin levels and augmentation index (AIx) response to Angiotensin II in women (r=0.37, p=0.023). In healthy subjects, increasing fasting insulin levels were significantly associated with a greater increase in stress-related arterial stiffness in women (r=0.37, p=0.023), a response not observed in men.
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