Relationship between insulin resistance and coronary artery calcium in young men and women.
BACKGROUND
The gender disparity in cardiovascular disease (CVD) risk is greatest between young men and women. However, the causes of that are not fully understood. The objective of this study was to evaluate the relationship between insulin resistance and the presence of coronary artery calcium (CAC) to identify risk factors that may predispose young men and women to CVD.


RESULTS
Insulin resistance and CVD risk factors were examined in 8682 Korean men and 1829 women aged 30-45 years old. Insulin resistance was estimated using the homeostasis model assessment of insulin resistance (HOMA-IR), and CAC was measured using computed tomography. Women were less likely to be insulin resistant (upper quartile of HOMA-IR, 18% vs. 27%, p<0.001) and had a lower prevalence of CAC (1.6% vs. 6.4%, p<0.001). Even when equally insulin resistant men and women were compared, women continued to have lower prevalence of CAC (3.1% vs. 7.2%, p = 0.004) and a more favorable CVD risk profile. Finally, after adjustment for traditional CVD risk factors, insulin resistance remained an independent predictor of CAC only in men (p = 0.03).


CONCLUSIONS
Young women have a lower risk for CVD and a lower CAC prevalence compared with men. This favorable CVD risk profile in women appears to occur regardless of insulin sensitivity. Unlike men, insulin resistance was not a predictor of CAC in women in this cohort. Therefore, insulin resistance has less impact on CVD risk and CAC in young women compared with men, and insulin resistance alone does not explain the gender disparity in CVD risk that is observed at an early age.
Division of Cardiology, Department of Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. kcmd.sung@samsung.com
Ki-Chul
KC
Sung
Jin-Ho
JH
Choi
Hyeon-Cheol
HC
Gwon
Seung-Hyuk
SH
Choi
Bum-Soo
BS
Kim
Hyon Joo
HJ
Kwag
Sun H
SH
Kim
D000328:Adult; D002118:Calcium / Q000378:metabolism*; D002318:Cardiovascular Diseases / Q000150:complications; D003331:Coronary Vessels / Q000378:metabolism* / Q000473:pathology; D048909:Diabetes Complications / Q000378:metabolism; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012307:Risk Factors
D002118:Calcium