title: Insulin, insulin propeptides and intima-media thickness in the carotid artery in 58-year-old clinically healthy men. The Atherosclerosis and Insulin Resistance study (AIR).
abstract: OBJECTIVE
  To examine the relationship between specific (intact) insulin, insulin propeptides and subclinical atherosclerosis.
  
  
  METHODS
  A cross-sectional study based on a stratified sampling of randomly selected, clinically healthy 58-year-old men (n = 391). Ultrasound examinations of the carotid arteries were performed with measurement of intima-media thickness (IMT) in the common carotid artery and in the carotid artery bulb. Fasting, cross-reacting plasma insulin (RIA), specific (intact) insulin, proinsulin, 32,33 split proinsulin and C-peptide were measured.
  
  
  RESULTS
  Plasma concentrations of cross-reacting plasma insulin, specific insulin, proinsulin, 32,33 split proinsulin and C-peptide were univariately associated with common carotid artery IMT. Established risk factors such as blood pressure, smoking, apoB, triglycerides, body mass index (BMI), and waist--hip ratio were also related to IMT. After adjustment for smoking, apoB, blood pressure and triglycerides, cross-reacting plasma insulin, proinsulin and C-peptide but not specific insulin and split 32,33 proinsulin remained associated with carotid artery IMT. No associations remained after adjustment for BMI.
  
  
  CONCLUSIONS
  Fasting plasma proinsulin, C-peptide, and insulin by cross-reacting RIA was associated with common carotid artery IMT independent of several conventional risk factors for atherosclerosis. The multicollinearity between the insulin peptides and propeptides makes it difficult to clarify the exact role of each peptide.
authors.affiliation: Department of Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden. lena.bokemark@wlab.wall.gu.se
authors.forename: L
authors.initials: L
authors.lastname: Bokemark
authors.forename: J
authors.initials: J
authors.lastname: Wikstrand
authors.forename: H
authors.initials: H
authors.lastname: Wedel
authors.forename: B
authors.initials: B
authors.lastname: Fagerberg
mesh_terms: D002339:Carotid Arteries / Q000000981:diagnostic imaging / Q000502:physiology*; D003430:Cross-Sectional Studies; D006801:Humans; D007328:Insulin / Q000097:blood*; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D011384:Proinsulin / Q000097:blood*; D012016:Reference Values; D011795:Surveys and Questionnaires; D017539:Tunica Intima / Q000502:physiology*; D017540:Tunica Media / Q000502:physiology*; D014463:Ultrasonography
chemical_list: D007328:Insulin; D011384:Proinsulin