Johns Hopkins Ciccarone Preventive Cardiology Center, Baltimore, Maryland.
Diabetes Care. 2011 Mar;34(3):749-51. doi: 10.2337/dc10-1681. Epub 2011 Feb 3.
We sought to determine whether insulin resistance predicts the incidence and progression of coronary artery calcification (CAC).
We studied 5,464 participants not on hypoglycemic therapy from the Multi-Ethnic Study of Atherosclerosis (MESA). Each had baseline homeostasis model assessment of insulin resistance (HOMA-IR) and baseline and follow-up CAC scores. Incident CAC was defined as newly detectable CAC; progression was defined as advancing CAC volume score at follow-up.
Median HOMA-IR was 1.2 (0.8-2.0). Across all ethnicities, there was a graded increase in CAC incidence and progression with increasing HOMA-IR. When compared with those in the 1st quartile, participants in the 2nd-4th quartiles had 1.2, 1.5, and 1.8 times greater risk of developing CAC. Median annualized CAC score progression was 8, 14, and 17 higher, respectively. However, HOMA-IR was not predictive after adjustment for metabolic syndrome components.
HOMA-IR predicts CAC incidence and progression, but not independently of metabolic syndrome.
我们旨在确定胰岛素抵抗是否可预测冠状动脉钙化（CAC）的发生和进展。
我们研究了来自动脉粥样硬化多民族研究（MESA）的 5464 名未接受降血糖治疗的参与者。他们均有基线稳态模型评估的胰岛素抵抗（HOMA-IR）和基线及随访 CAC 评分。新发 CAC 定义为新出现的 CAC；进展定义为随访时 CAC 体积评分增加。
中位数 HOMA-IR 为 1.2（0.8-2.0）。在所有种族中，随着 HOMA-IR 的增加，CAC 的发生率和进展呈梯度增加。与第 1 四分位组相比，第 2-4 四分位组发生 CAC 的风险分别增加 1.2、1.5 和 1.8 倍。中位数 CAC 评分每年进展分别增加 8、14 和 17。然而，在调整代谢综合征成分后，HOMA-IR 并不具有预测性。
HOMA-IR 可预测 CAC 的发生和进展，但不能独立于代谢综合征。
