Fakhrzadeh Hossein, Sharifi Farshad, Alizadeh Mahtab, Arzaghi Seyed Masoud, Tajallizade-Khoob Yaser, Tootee Ali, Alatab Sudabeh, Mirarefin Mojde, Badamchizade Zohre, Kazemi Hadi
Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Fourth Floor, No 4th, Ostad Nejatollahi Street, Enghelab Avenue, Tehran, 15996615 Iran.
Endocrinology and Metabolism Research Center, Tehran University of Medical Sciences, Tehran, Iran.
J Diabetes Metab Disord. 2016 Oct 1;15:41. doi: 10.1186/s40200-016-0263-5. eCollection 2015.
Insulin resistance is of utmost importance as an underlying mechanism for increased risk of cardiovascular disease (CVD). We assessed the association between Homeostatic Model Assessment (HOMA-IR) and two surrogate subclinical atherosclerosis markers (SCA) among individuals with and without type 2 diabetes (DM), those who did not have any clinical presentation of the CVD.
In a cross-sectional study, 208 participants (105 diabetics and 103 non-diabetics) were enrolled from referred patients with diabetes to an academic outpatient clinic and their non-diabetic relatives in-law. Fasting serum levels of insulin, blood glucose and lipid profile, were measured. Anthropometric and blood pressure were measuremented standardly. Body Mass Index (BMI) and Homeostatic Model Assessment-Insulin Resistance (HOMA-IR) index were calculated. Coronary Artery Calcium Score(CACS) was measured using a Multi-Detctor CT scanner. Flow mediated dilation (FMD) was measured using bimode ultrasonography (with linear transducer 13,000 MHZ). Univariate and multivariate logistic regression models were used to evaluate the association between these SCA markers and HOMA index in adjusting models.
CACS and HOMA-IR were higher and FMD was lower in diabetic participants than non-diabetic ones ( < 0.01) In a stepwise logistic regression model, CACS and FMD were associated with HOMA-IR (odds ratio = 1.778; 95 % confidence interval (CI): 1.211-2.726 and odds ratio = 1.557; 95 % CI: 1.601-2.275, respectively) in non-diabetics but not among diabetic participants.
CACS and FMD are related to insulin resistance among non-diabetic individuals, but we could not find this relationship among diabetic patients.
胰岛素抵抗作为心血管疾病（CVD）风险增加的潜在机制至关重要。我们评估了稳态模型评估（HOMA-IR）与两种替代亚临床动脉粥样硬化标志物（SCA）之间的关联，这些个体患有或未患有2型糖尿病（DM），且没有任何CVD的临床表现。
在一项横断面研究中，从转诊至学术门诊的糖尿病患者及其非糖尿病姻亲中招募了208名参与者（105名糖尿病患者和103名非糖尿病患者）。测量空腹血清胰岛素、血糖和血脂水平。标准测量人体测量指标和血压。计算体重指数（BMI）和稳态模型评估胰岛素抵抗（HOMA-IR）指数。使用多排CT扫描仪测量冠状动脉钙化评分（CACS）。使用双模式超声（线性换能器13,000兆赫）测量血流介导的血管舒张（FMD）。使用单变量和多变量逻辑回归模型在调整模型中评估这些SCA标志物与HOMA指数之间的关联。
糖尿病参与者的CACS和HOMA-IR较高，FMD较低，与非糖尿病参与者相比差异有统计学意义（<0.01）。在逐步逻辑回归模型中，非糖尿病参与者的CACS和FMD与HOMA-IR相关（比值比分别为1.778；95%置信区间（CI）：1.211 - 2.726和比值比为1.557；95%CI：1.601 - 2.275），但在糖尿病参与者中未发现这种关系。
CACS和FMD与非糖尿病个体的胰岛素抵抗有关，但在糖尿病患者中未发现这种关系。
