Relationship between simple markers of insulin resistance and coronary artery calcification

Gerald M. Reaven, Joshua W. Knowles, David Leonard, Carolyn E. Barlow, Benjamin L. Willis, William L. Haskell, David J. Maron

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background: Insulin resistance in apparently healthy persons is associated with a cluster of metabolic abnormalities that promote coronary atherosclerosis. Identifying these individuals before manifest disease would provide useful clinical information. Objective: We hypothesized that combining 2 simple markers of insulin resistance, prediabetes (PreDM) and triglyceride (TG) concentration ≥150 mg/dL, would identify apparently healthy persons with adverse cardiometabolic risk profiles and increased coronary artery calcium (CAC) compared with those with neither or only 1 abnormality. Methods: A cross-sectional analysis was performed using data from 25,886 apparently healthy individuals (18,453 men and 7433 women) evaluated at the Cooper Clinic from 1998 to 2015. Participants were divided into those with a normal fasting glucose concentrations (<100 mg/dL = normal fasting glucose) or PreDM (fasting plasma glucose ≥100 and <126 mg/dL) and further subdivided into those with a plasma TG concentration <150 or ≥150 mg/dL. These 4 groups were compared on the basis of multiple coronary artery disease risk factors and the presence of CAC determined during their evaluation. Results: Participants with PreDM and a TG concentration ≥150 mg/dL had a significantly more adverse coronary artery disease risk profile than individuals with either abnormality or only 1 abnormality (PreDM or TG concentration ≥150 mg/dL). Furthermore, the odds of detectable CAC were higher in participants with PreDM and a TG ≥ 150 mg/dL than in participants with neither or only 1 abnormality. Conclusion: The presence of 2 markers of insulin resistance, PreDM and TG concentration ≥150 mg/dL, is associated with increased cardiometabolic risk and detectable CAC within a population of apparently healthy individuals.

Original languageEnglish (US)
JournalJournal of Clinical Lipidology
DOIs
StateAccepted/In press - 2017

Fingerprint

Insulin Resistance
Coronary Vessels
Triglycerides
Calcium
Coronary Artery Disease
Fasting
Glucose
Prediabetic State
Cross-Sectional Studies
Population

Keywords

  • Cardiometabolic risk
  • Coronary artery calcium
  • Hypertriglyceridemia
  • Insulin resistance
  • Prediabetes

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Nutrition and Dietetics
  • Cardiology and Cardiovascular Medicine

Cite this

Reaven, G. M., Knowles, J. W., Leonard, D., Barlow, C. E., Willis, B. L., Haskell, W. L., & Maron, D. J. (Accepted/In press). Relationship between simple markers of insulin resistance and coronary artery calcification. Journal of Clinical Lipidology. https://doi.org/10.1016/j.jacl.2017.05.013

Relationship between simple markers of insulin resistance and coronary artery calcification. / Reaven, Gerald M.; Knowles, Joshua W.; Leonard, David; Barlow, Carolyn E.; Willis, Benjamin L.; Haskell, William L.; Maron, David J.

In: Journal of Clinical Lipidology, 2017.

Research output: Contribution to journalArticle

Reaven, Gerald M. ; Knowles, Joshua W. ; Leonard, David ; Barlow, Carolyn E. ; Willis, Benjamin L. ; Haskell, William L. ; Maron, David J. / Relationship between simple markers of insulin resistance and coronary artery calcification. In: Journal of Clinical Lipidology. 2017.
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N2 - Background: Insulin resistance in apparently healthy persons is associated with a cluster of metabolic abnormalities that promote coronary atherosclerosis. Identifying these individuals before manifest disease would provide useful clinical information. Objective: We hypothesized that combining 2 simple markers of insulin resistance, prediabetes (PreDM) and triglyceride (TG) concentration ≥150 mg/dL, would identify apparently healthy persons with adverse cardiometabolic risk profiles and increased coronary artery calcium (CAC) compared with those with neither or only 1 abnormality. Methods: A cross-sectional analysis was performed using data from 25,886 apparently healthy individuals (18,453 men and 7433 women) evaluated at the Cooper Clinic from 1998 to 2015. Participants were divided into those with a normal fasting glucose concentrations (<100 mg/dL = normal fasting glucose) or PreDM (fasting plasma glucose ≥100 and <126 mg/dL) and further subdivided into those with a plasma TG concentration <150 or ≥150 mg/dL. These 4 groups were compared on the basis of multiple coronary artery disease risk factors and the presence of CAC determined during their evaluation. Results: Participants with PreDM and a TG concentration ≥150 mg/dL had a significantly more adverse coronary artery disease risk profile than individuals with either abnormality or only 1 abnormality (PreDM or TG concentration ≥150 mg/dL). Furthermore, the odds of detectable CAC were higher in participants with PreDM and a TG ≥ 150 mg/dL than in participants with neither or only 1 abnormality. Conclusion: The presence of 2 markers of insulin resistance, PreDM and TG concentration ≥150 mg/dL, is associated with increased cardiometabolic risk and detectable CAC within a population of apparently healthy individuals.

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