Johns Hopkins Ciccarone Preventive Cardiology Center, Baltimore, MD 21287, USA.
Atherosclerosis. 2011 Oct;218(2):507-10. doi: 10.1016/j.atherosclerosis.2011.06.047. Epub 2011 Jul 6.
We hypothesized that insulin resistance, measured by the homeostasis model assessment of insulin resistance (HOMA), is independently associated with prevalent and incident extra-coronary calcification (ECC).
We studied calcium scores of the aortic valve calcification (AVC), mitral valve calcification (MVC), thoracic aorta calcification (TAC) and aortic valve root calcification (AVR) in 6104 MESA participants not on diabetes medication who had baseline cardiac CT scans; 5312 had follow-up scans (mean 2.4 years). Relative-risk regression modeled prevalent and incident ECC adjusted for baseline demographics (model 1), and additionally for CVD risk factors (model 2).
In model 1, prevalence and incidence risk-ratios for the highest versus lowest quartile of HOMA were 20-30% higher in all ECC locations (p-value for trend ≤0.05 for all but incident-AVC). In model 2, all associations were attenuated, primarily by adjustment for metabolic syndrome components.
HOMA has a positive and graded association with ECC, but not independently of cardiovascular risk factors-particularly metabolic syndrome components.
我们假设通过稳态模型评估胰岛素抵抗（HOMA）测量的胰岛素抵抗与普遍存在和新发的冠状动脉外钙化（ECC）独立相关。
我们研究了 6104 名未服用糖尿病药物且基线心脏 CT 扫描存在主动脉瓣钙化（AVC）、二尖瓣钙化（MVC）、胸主动脉钙化（TAC）和主动脉瓣根部钙化（AVR）的 MESA 参与者的钙评分; 5312 名参与者有随访扫描（平均 2.4 年）。相对风险回归模型调整了基线人口统计学因素（模型 1）和 CVD 危险因素（模型 2）的普遍存在和新发 ECC。
在模型 1 中，与 HOMA 最低四分位数相比，所有 ECC 部位的患病率和发病率风险比高 20-30%（除了新发-AVC 之外，所有趋势的 p 值均<0.05）。在模型 2 中，所有关联均减弱，主要是通过调整代谢综合征成分。
HOMA 与 ECC 呈正相关且呈分级相关，但与心血管危险因素无关-特别是代谢综合征成分。
