TY - JOUR
T1 - Insulin resistance and the development of cardiovascular disease in a Japanese community
T2 - The Hisayama study
AU - Gotoh, Seiji
AU - Doi, Yasufumi
AU - Hata, Jun
AU - Ninomiya, Toshiharu
AU - Mukai, Naoko
AU - Fukuhara, Masayo
AU - Kamouchi, Masahiro
AU - Kitazono, Takanari
AU - Kiyohara, Yutaka
N1 - Copyright:
Copyright 2013 Elsevier B.V., All rights reserved.
PY - 2012
Y1 - 2012
N2 - Aims: Although several surrogate measures of insulin resistance have been proposed, their associations with cardiovascular disease (CVD) have not been evaluated sufficiently. Methods: A total of 2,356 community-dwelling Japanese individuals aged 40 to 79 years who underwent a 75 g oral glucose tolerance test were followed up for 14 years. The status of insulin resistance was estimated by using the Matsuda index or homeostasis model assessment of insulin resistance (HOMA-IR). Results: During follow-up, 260 subjects developed CVD. The age-and sex-adjusted hazard ratios of CVD significantly decreased with an increasing Matsuda index and rose with increasing HOMA-IR levels (both p for trend <0.05). After adjustment for age, sex, serum total cholesterol, electrocardiogram abnormalities, proteinuria, smoking habits, alcohol intake, and regular exercise, the risk of CVD was significantly lower in the third to fifth quintiles of the Matsuda index and higher in the fifth quintile of HOMA-IR values compared with the first quintile of the corresponding index (Matsuda index Q3: hazard ratio (HR) = 0.59 [95% confidence interval 0.40-0.87]; Q4: HR = 0.66 [0.45-0.97]; and Q5: HR = 0.67 [0.47-0.97]; HOMA-IR Q5: HR = 1.55 [1.05-2.29]); however, these associations were attenuated after further adjustment for the metabolic syndrome status. In regard to CVD subtypes, the risks for stroke and coronary heart disease significantly decreased with an increasing Matsuda index, while elevated HOMA-IR levels were a significant risk factor for stroke, but not for coronary heart disease. Conclusion: Our findings suggest that insulin resistance significantly increases the risk of incident CVD through metabolic syndrome in Japanese.
AB - Aims: Although several surrogate measures of insulin resistance have been proposed, their associations with cardiovascular disease (CVD) have not been evaluated sufficiently. Methods: A total of 2,356 community-dwelling Japanese individuals aged 40 to 79 years who underwent a 75 g oral glucose tolerance test were followed up for 14 years. The status of insulin resistance was estimated by using the Matsuda index or homeostasis model assessment of insulin resistance (HOMA-IR). Results: During follow-up, 260 subjects developed CVD. The age-and sex-adjusted hazard ratios of CVD significantly decreased with an increasing Matsuda index and rose with increasing HOMA-IR levels (both p for trend <0.05). After adjustment for age, sex, serum total cholesterol, electrocardiogram abnormalities, proteinuria, smoking habits, alcohol intake, and regular exercise, the risk of CVD was significantly lower in the third to fifth quintiles of the Matsuda index and higher in the fifth quintile of HOMA-IR values compared with the first quintile of the corresponding index (Matsuda index Q3: hazard ratio (HR) = 0.59 [95% confidence interval 0.40-0.87]; Q4: HR = 0.66 [0.45-0.97]; and Q5: HR = 0.67 [0.47-0.97]; HOMA-IR Q5: HR = 1.55 [1.05-2.29]); however, these associations were attenuated after further adjustment for the metabolic syndrome status. In regard to CVD subtypes, the risks for stroke and coronary heart disease significantly decreased with an increasing Matsuda index, while elevated HOMA-IR levels were a significant risk factor for stroke, but not for coronary heart disease. Conclusion: Our findings suggest that insulin resistance significantly increases the risk of incident CVD through metabolic syndrome in Japanese.
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U2 - 10.5551/jat.13698
DO - 10.5551/jat.13698
M3 - Article
C2 - 22814404
AN - SCOPUS:84870747612
VL - 19
SP - 977
EP - 985
JO - Journal of Atherosclerosis and Thrombosis
JF - Journal of Atherosclerosis and Thrombosis
SN - 1340-3478
IS - 11
ER -