title: Low insulin sensitivity measured by both quantitative insulin sensitivity check index and homeostasis model assessment method as a risk factor of increased intima-media thickness of the carotid artery.
abstract: The present study evaluated the association of ultrasonographic manifestations of carotid atherosclerosis with glucose status, various components of the insulin resistance syndrome, and insulin sensitivity measured by a novel quantitative insulin sensitivity check index (QUICKI = 1/[log(I0) + log (G0)]). Carotid ultrasonographic measurements were performed on 54 diabetic subjects, 97 subjects with impaired glucose tolerance and 57 normoglycemic subjects. QUICKI and insulin resistance measured by a HOMA (homeostasis model assessment) method had a high negative correlation (r = -0.995, P < 0.001). QUICKI was lower in diabetic subjects (0.319 +/- 0.022) than in subjects with impaired glucose tolerance (0.334 +/- 0.027) or normoglycemia (0.335 +/- 0.022, P = 0.002). There was an increasing trend in the mean and maximal intima-media thickness (IMT) of the common carotid artery (CCA) with worsening of glucose status. The maximal IMT of the CCA correlated inversely with QUICKI (r = -0.158, P = 0.027). The prevalence of severe CCA atherosclerosis (maximal IMT of the CCA > or = 1.2 mm) was 41% in men and 16% in women (P < 0.001). It was also associated with a long (> or =26 yr) smoking history. The prevalence of severe CCA atherosclerosis was 11% in the highest QUICKI tertile, 36% in the middle tertile, and 33% in the lowest tertile (P = 0.002). Systolic blood pressure was higher and high-density lipoprotein cholesterol lower in subjects with severe CCA atherosclerosis, compared with those without it. In multiple regression analysis, the adjusted odds ratio for severe CCA atherosclerosis was 5.7 (95% confidence interval, 2.2-15.1) in subjects in the two lowest tertiles of QUICKI, compared with those in the highest tertile.
authors.affiliation: Department of Public Health Science and General Practice, University Hospital, University of Oulu, Aapistie 1, 90220 Oulu, Finland. urajala@cc.oulu.fi
authors.forename: Ulla
authors.initials: U
authors.lastname: Rajala
authors.forename: Mauri
authors.initials: M
authors.lastname: Laakso
authors.forename: Markku
authors.initials: M
authors.lastname: Päivänsalo
authors.forename: Outi
authors.initials: O
authors.lastname: Pelkonen
authors.forename: Ilkka
authors.initials: I
authors.lastname: Suramo
authors.forename: Sirkka
authors.initials: S
authors.lastname: Keinänen-Kiukaanniemi
mesh_terms: D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure; D002339:Carotid Arteries / Q000000981:diagnostic imaging*; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging* / Q000453:epidemiology; D008076:Cholesterol, HDL / Q000097:blood; D005215:Fasting; D005260:Female; D018149:Glucose Intolerance / Q000453:epidemiology; D006706:Homeostasis; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D007328:Insulin / Q000097:blood / Q000494:pharmacology*; D007333:Insulin Resistance; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012044:Regression Analysis; D012307:Risk Factors; D012727:Sex Characteristics; D012907:Smoking / Q000453:epidemiology; D014280:Triglycerides / Q000097:blood; D014463:Ultrasonography
chemical_list: D001786:Blood Glucose; D008076:Cholesterol, HDL; D007328:Insulin; D014280:Triglycerides