Early insulin resistance in normoglycemic low-risk individuals is associated with subclinical atherosclerosis
Main finding · Multiterritorial extent of subclinical atherosclerosisResult — go to the resultOdds ratio 1.41 95% CI 1.01–1.95Authors' conclusion
The use of HOMA-IR identified low-risk individuals with a higher burden of SA, after adjusting for the effects of key traditional CVRFs and HbA1c. HOMA-IR is a simple measure that could facilitate earlier implementation of primary CV prevention strategies in clinical practice.
Study context
- Population
- Middle-aged individuals from the PESA study with basal HbA1c <6.0% (<42 mmol/mol) and no known CVD
- Participants
- 3,741 individuals
- Exposure
- HOMA-IR ≥3 vs HOMA-IR <2
- Outcome
- Presence, burden and extent of subclinical atherosclerosis (multiterritorial vascular US and coronary artery calcium score)
Main finding
As reported in the abstract
Multiterritorial extent of subclinical atherosclerosis
Odds ratio
1.41
95% CI 1.01–1.95
P = 0.041
HOMA-IR ≥ 3vs HOMA-IR < 2
OR 1.41 (95% CI 1.01–1.95); P = 0.041
- HOMA-IR directly associated with multiterritorial extent of subclinical atherosclerosis (SA) and CACS
- P < 0.001
Observational data: associations, not effects.
Further findings
| Outcome | OR (95% CI) | P value | |
|---|---|---|---|
| CACS > 0 | 1.74 (1.20–2.54) | P = 0.004 | |
| 0.20.5125Odds ratio (log scale) |
- CACS > 0: adjusted for key cardiovascular risk factors (CVRFs) and HbA1c
Global plaque volume by 3-dimensional vascular US
- Direct association of HOMA-IR with global plaque volume
- P < 0.001
Stratified by SCORE2 risk
- Association remained significant in low-to-moderate SCORE2 risk individuals (75.6% of the cohort) but not in high-risk individuals
Original publication
Early insulin resistance in normoglycemic low-risk individuals is associated with subclinical atherosclerosis. Cardiovasc Diabetol. Published 19 December 2023. doi:10.
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