title: The relationship of insulin resistance and extracoronary calcification in the multi-ethnic study of atherosclerosis.
abstract: OBJECTIVE
  We hypothesized that insulin resistance, measured by the homeostasis model assessment of insulin resistance (HOMA), is independently associated with prevalent and incident extra-coronary calcification (ECC).
  
  
  METHODS
  We studied calcium scores of the aortic valve calcification (AVC), mitral valve calcification (MVC), thoracic aorta calcification (TAC) and aortic valve root calcification (AVR) in 6104 MESA participants not on diabetes medication who had baseline cardiac CT scans; 5312 had follow-up scans (mean 2.4 years). Relative-risk regression modeled prevalent and incident ECC adjusted for baseline demographics (model 1), and additionally for CVD risk factors (model 2).
  
  
  RESULTS
  In model 1, prevalence and incidence risk-ratios for the highest versus lowest quartile of HOMA were 20-30% higher in all ECC locations (p-value for trend ≤0.05 for all but incident-AVC). In model 2, all associations were attenuated, primarily by adjustment for metabolic syndrome components.
  
  
  CONCLUSIONS
  HOMA has a positive and graded association with ECC, but not independently of cardiovascular risk factors-particularly metabolic syndrome components.
authors.affiliation: Johns Hopkins Ciccarone Preventive Cardiology Center, Baltimore, MD 21287, USA. gtison@jhmi.edu
authors.forename: Geoffrey H
authors.initials: GH
authors.lastname: Tison
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Blaha
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Budoff
authors.forename: Ronit
authors.initials: R
authors.lastname: Katz
authors.forename: Juan J
authors.initials: JJ
authors.lastname: Rivera
authors.forename: Alain G
authors.initials: AG
authors.lastname: Bertoni
authors.forename: Nathan D
authors.initials: ND
authors.lastname: Wong
authors.forename: Roger S
authors.initials: RS
authors.lastname: Blumenthal
authors.forename: Moyses
authors.initials: M
authors.lastname: Szklo
authors.forename: John
authors.initials: J
authors.lastname: Eng
authors.forename: Russell
authors.initials: R
authors.lastname: Tracy
authors.forename: Khurram
authors.initials: K
authors.lastname: Nasir
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000473:pathology; D050197:Atherosclerosis / Q000208:ethnology* / Q000378:metabolism*; D002114:Calcinosis; D002118:Calcium / Q000378:metabolism; D005006:Ethnicity; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012044:Regression Analysis; D012306:Risk; D012307:Risk Factors
chemical_list: D002118:Calcium