Biomarkers of glucose-insulin homeostasis and incident type 2 diabetes and cardiovascular disease: results from the Vitamin D and Omega-3 trial
Authors' conclusion
Each of insulin, C-peptide, IRS, and HbA1c were associated with incident T2D with the strongest association noted for HbA1c. While HbA1c was significantly associated with CVD risk, a novel IRS appears to be associated with CHD risk. Neither vitamin D nor n-3 FA modified the associations between these biomarkers and cardiometabolic outcomes.
Study context
- Population
- Participants of the VITamin D and OmegA-3 TriaL with incident T2D or cardiovascular disease (CVD) and matched controls; median 5.3 years218 T2D and 715 CVD pairs
- Comparison
- Baseline insulin, C-peptide, HbA1c and insulin resistance score (IRS) (per SD) and incident T2D, CVD and CHD; effect modification by randomized vitamin D or n-3 FA
- Primary endpoint
- Incident T2D, CVD (cardiovascular death, MI, stroke, coronary revascularization) and CHD; aOR per SD of baseline biomarker
- Follow-up
- Median 5.3 years
Methodological detailscases matched 1:1 to controls on age, sex and fasting status, conditional logistic regression
- Cases matched 1:1 to controls on age, sex and fasting status
- Conditional logistic regression
Primary result
As reported in the abstract
Incident T2D, aOR per SD increment of baseline biomarker
Insulin, aOR
1.46 (1.03, 2.06) (95% CI)
C-peptide, aOR
2.04 (1.35, 3.09) (95% CI)
IRS, aOR
1.72 (1.28, 2.31) (95% CI)
HbA1c, aOR
7.00 (3.76, 13.02) (95% CI)
Further findings
Incident CVD and CHD, aOR per SD
- HbA1c with CVD, aOR
- 1.19 [1.02, 1.39] (95% CI)
- IRS with CHD, aOR
- 1.25 [1.04, 1.50] (95% CI)
- Only these significant; persisted after mutual adjustment
- 423 incident CHD pairs
Effect modification by randomized vitamin D and/or n-3 FA
- Randomization to vitamin D and/or n-3 FA did not modify the associations
Original publication
Biomarkers of glucose-insulin homeostasis and incident type 2 diabetes and cardiovascular disease: results from the Vitamin D and Omega-3 trial. Cardiovasc Diabetol. Published 2 November 2024. doi:10.
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