title: The relationship between insulin resistance and incidence and progression of coronary artery calcification: the Multi-Ethnic Study of Atherosclerosis (MESA).
abstract: OBJECTIVE
  We sought to determine whether insulin resistance predicts the incidence and progression of coronary artery calcification (CAC).
  
  
  METHODS
  We studied 5,464 participants not on hypoglycemic therapy from the Multi-Ethnic Study of Atherosclerosis (MESA). Each had baseline homeostasis model assessment of insulin resistance (HOMA-IR) and baseline and follow-up CAC scores. Incident CAC was defined as newly detectable CAC; progression was defined as advancing CAC volume score at follow-up.
  
  
  RESULTS
  Median HOMA-IR was 1.2 (0.8-2.0). Across all ethnicities, there was a graded increase in CAC incidence and progression with increasing HOMA-IR. When compared with those in the 1st quartile, participants in the 2nd-4th quartiles had 1.2, 1.5, and 1.8 times greater risk of developing CAC. Median annualized CAC score progression was 8, 14, and 17 higher, respectively. However, HOMA-IR was not predictive after adjustment for metabolic syndrome components.
  
  
  CONCLUSIONS
  HOMA-IR predicts CAC incidence and progression, but not independently of metabolic syndrome.
authors.affiliation: Johns Hopkins Ciccarone Preventive Cardiology Center, Baltimore, Maryland. mblaha1@jhmi.edu
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Blaha
authors.forename: Andrew P
authors.initials: AP
authors.lastname: DeFilippis
authors.forename: Juan J
authors.initials: JJ
authors.lastname: Rivera
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Budoff
authors.forename: Ron
authors.initials: R
authors.lastname: Blankstein
authors.forename: Arthur
authors.initials: A
authors.lastname: Agatston
authors.forename: Moyses
authors.initials: M
authors.lastname: Szklo
authors.forename: Susan G
authors.initials: SG
authors.lastname: Lakoski
authors.forename: Alain G
authors.initials: AG
authors.lastname: Bertoni
authors.forename: Richard A
authors.initials: RA
authors.lastname: Kronmal
authors.forename: Roger S
authors.initials: RS
authors.lastname: Blumenthal
authors.forename: Khurram
authors.initials: K
authors.lastname: Nasir
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002114:Calcinosis / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology*; D003324:Coronary Artery Disease / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology; D005260:Female; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology*; D008297:Male; D008875:Middle Aged