Lower insulin sensitivity as an independent risk factor for carotid wall thickening in normotensive, non-diabetic, non-smoking normal weight and obese premenopausal women.
OBJECTIVE
Increased thickness of the intima-media complex of the common carotid artery (IMT-CCA) is an early marker of atherosclerosis. The aim of the present study was to investigate the relationship between insulin resistance and IMT-CCA in premenopausal women.


METHODS
86 young women, aged 18-31 y, were recruited for the study: 28 were normal weight (BMI<25 kg/m2), 23 were overweight (BMI 25-30 kg/m2) and 35 were obese (BMI>30 kg/m2).


METHODS
The IMT-CCA was measured by high resolution 'B-mode' ultrasonography; insulin sensitivity was determined by insulin tolerance test (ITT) and quantitated by calculation of KITT. Fasting plasma glucose and lipids (triglycerides, total and HDL-cholesterol) were also measured by enzymatic methods. Central fat accumulation was evaluated by measuring waist circumference (WC).


RESULTS
IMT-CCA showed an inverse association with KITT (P<0.05). When the IMT-CCA was considered as the dependent variable in a forward stepwise multiple regression analysis, it maintained an independent association with KITT (P<0.05), after adjusting data for age, BMI, WC, mean blood pressure levels and plasma glucose and lipids.


CONCLUSIONS
These results suggest that IMT-CCA is significantly associated with insulin resistance, independent of other well-known CVD risk factors. Since the IMT-CCA is an earlier asymptomatic sign of atherosclerosis, this study indicates that insulin resistance per se may accelerate atherogenesis.
De Pergola
G
G
Istituto di Clinica Medica, Endocrinologia e Malattie Metaboliche, University of Bari, Bari, Italy. depergio@iqsnet.it
Ciccone
M
M
Pannacciulli
N
N
Modugno
M
M
Sciaraffia
M
M
Minenna
A
A
Rizzon
P
P
Giorgino
R
R
D000293:Adolescent; D000328:Adult; D001786:Blood Glucose / Q000032:analysis; D001835:Body Weight / Q000502:physiology*; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy; D005260:Female; D006801:Humans; D007328:Insulin / Q000008:administration & dosage / Q000097:blood; D007333:Insulin Resistance / Q000502:physiology*; D007558:Italy; D008055:Lipids / Q000097:blood; D009765:Obesity / Q000150:complications* / Q000503:physiopathology; D012044:Regression Analysis; D012307:Risk Factors; D014463:Ultrasonography
D001786:Blood Glucose; D007328:Insulin; D008055:Lipids