Department of Family Medicine, Chang-Gung Memorial Hospital, Linkou Branch, Taoyuan City 33305, Taiwan.
. Department of Family Medicine, Chang Gung Memorial Hospital, Taoyuan Branch, Taoyuan City 33378, Taiwan.
Int J Environ Res Public Health. 2020 Oct 1;17(19):7195. doi: 10.3390/ijerph17197195.
Previous studies have implied that insulin resistance (IR) could represent a major underlying abnormality leading to cardiovascular disease (CVD). The aim of this study was to evaluate the relationships between IR (estimated by the homeostasis model assessment of IR (HOMA-IR) index) and CVD risk among middle-aged and elderly Taiwanese individuals.
In this cross-sectional, community-based study, a total of 320 participants were interviewed to collect demographical parameters and blood samples. The recruited participants were divided into tertiles according to their levels of HOMA-IR. The Framingham risk score (FRS) was calculated according to the 2008 general CVD risk model from the Framingham Heart Study.
The HOMA-IR index was significantly correlated with the FRS, with a Pearson's coefficient of 0.22. In the multiple logistic regression model, a higher HOMA-IR level was significantly associated with a high FRS (FRS ≥ 20%) (highest tertile vs. lowest tertile of HOMA-IR, crude OR = 3.69; 95% CI = 1.79-7.62), even after adjusting for smoking, fasting plasma glucose (FPG), and systolic blood pressure (SBP) (highest tertile vs. lowest tertile of HOMA-IR, adjusted OR = 11.51; 95% CI = 2.55-51.94). The area under the receiver operating characteristic curve for the HOMA-IR index as the predictor of high FRS was 0.627, and the optimal HOMA-IR cutoff value was 1.215 (sensitivity = 83.6%, specificity = 42.9%).
We considered that HOMA-IR is an independent factor but that it cannot be used solely for evaluating the CVD risk due to the low AUC value. Further prospective cohort studies are warranted to better assess the relationship between CVD risk and insulin resistance.
先前的研究表明，胰岛素抵抗（IR）可能代表导致心血管疾病（CVD）的主要潜在异常。本研究旨在评估中年和老年台湾个体中 IR（通过稳态模型评估的 IR（HOMA-IR）指数估计）与 CVD 风险之间的关系。
在这项横断面、基于社区的研究中，共对 320 名参与者进行访谈以收集人口统计学参数和血液样本。根据 HOMA-IR 水平将招募的参与者分为三分位组。根据弗雷明汉心脏研究的 2008 年一般 CVD 风险模型计算弗雷明汉风险评分（FRS）。
HOMA-IR 指数与 FRS 显著相关，Pearson 相关系数为 0.22。在多元逻辑回归模型中，较高的 HOMA-IR 水平与高 FRS（FRS≥20%）显著相关（HOMA-IR 最高三分位组与最低三分位组相比，未调整的 OR=3.69；95%CI=1.79-7.62），即使在调整了吸烟、空腹血糖（FPG）和收缩压（SBP）后（HOMA-IR 最高三分位组与最低三分位组相比，调整后的 OR=11.51；95%CI=2.55-51.94）。HOMA-IR 指数作为高 FRS 预测因子的受试者工作特征曲线下面积为 0.627，最佳 HOMA-IR 截断值为 1.215（灵敏度=83.6%，特异性=42.9%）。
我们认为 HOMA-IR 是一个独立的因素，但由于 AUC 值较低，不能单独用于评估 CVD 风险。需要进一步的前瞻性队列研究来更好地评估 CVD 风险与胰岛素抵抗之间的关系。
