title: Insulin resistance and other risk factors for coronary heart disease in elderly men. The Study of Men Born in 1913 and 1923.
abstract: BACKGROUND
  We have previously shown that insulin is not a major risk factor for CHD. Our data have been re-analysed with longer follow-up and the homeostasis model assessment (HOMA) method.
  
  
  METHODS
  Prospective cohort study of 57- and 67-year-old men.
  
  
  METHODS
  Insulin resistance was estimated with the HOMA equation. Standard methods were used to measure risk factors. The endpoint (CHD) was the combination of non-fatal myocardial infarction and fatal CHD during 13 years of follow-up.
  
  
  RESULTS
  The risk of CHD increased 2.5-fold in known diabetics compared with those with normal glucose tolerance, 2.2-fold among those in the highest compared with the lowest quintile of insulin resistance, and 2.4-fold among those in the highest compared with the lowest quintile of fasting insulin. Increased physical activity decreased the risk of CHD by 65%. Cholesterol was also a significant risk factor for CHD but blood pressure, obesity and smoking were not related to the incidence of CHD.
  
  
  CONCLUSIONS
  Insulin resistance is a significant risk factor for CHD. Whether it is a causal risk factor remains to be proven. Regular physical activity protects against CHD.
authors.affiliation: Department of Medicine, Lidköping Hospital, Göteborg University, Sweden. lennart.x.welin@vgregion.se
authors.forename: Lennart
authors.initials: L
authors.lastname: Welin
authors.forename: Lars E
authors.initials: LE
authors.lastname: Bresäter
authors.forename: Henry
authors.initials: H
authors.lastname: Eriksson
authors.forename: Per O
authors.initials: PO
authors.lastname: Hansson
authors.forename: Catharina
authors.initials: C
authors.lastname: Welin
authors.forename: Annika
authors.initials: A
authors.lastname: Rosengren
mesh_terms: D000367:Age Factors; D000368:Aged; D015331:Cohort Studies; D003327:Coronary Disease / Q000453:epidemiology* / Q000209:etiology*; D005215:Fasting / Q000097:blood*; D005500:Follow-Up Studies; D018149:Glucose Intolerance / Q000150:complications*; D006801:Humans; D015994:Incidence; D007328:Insulin / Q000097:blood*; D007333:Insulin Resistance; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D013548:Sweden / Q000453:epidemiology; D013997:Time Factors
chemical_list: D007328:Insulin