title: The echogenicity of the intima-media complex in the common carotid artery is related to insulin resistance measured by the hyperinsulinemic clamp in elderly men.
abstract: The echogenicity of the intima-media complex (IM-GSM) has recently been shown to be related to the echogenicity in carotid artery plaque and to predict cardiovascular (CV) mortality. The present study aims to evaluate the relationship between metabolic CV risk factors, with special emphasis on insulin resistance, and IM-GSM in the carotid artery. Carotid artery ultrasound with grey-scale median analysis of the intima-media complex, IM-GSM, was performed in a population sample of 480 men aged 75 years. In these subjects, a euglycemic hyperinsulinemic clamp to investigate insulin resistance was performed together with measurements of conventional CV risk factors at the age of 70. The metabolic syndrome (MetS) was defined by the NCEP/ATPIII-criteria. In univariate analysis, IM-GSM in the common carotid artery was inversely correlated with the intima-media thickness (IMT), body mass index (BMI), waist/hip ratio, fasting glucose, serum triglycerides, low HDL cholesterol and insulin resistance at the clamp (r = -0·24, P<0·001). In multiple regression analysis, only insulin resistance at the clamp and BMI were independently related to IM-GSM. Subjects with the MetS (22%) showed a reduced IM-GSM when compared to those without (64 ± 20 SD versus 68 ± 19, P<0·05). Because the echogenicity of the intima-media complex in the carotid artery is related to obesity and insulin resistance at clamp independently of IMT, this new vascular characteristic would serve as a marker of vascular alterations induced by insulin resistance and the MetS and has the advantage to be obtainable in almost all subjects.
authors: Department of Medicine, Uppsala University, Uppsala, Sweden. lars.lind@medsci.uu.se
authors: Lars
authors: L
authors: Lind
authors: Martin
authors: M
authors: Wohlin
authors: Bertil
authors: B
authors: Andren
authors: Johan
authors: J
authors: Sundström
mesh_terms: D000367:Age Factors; D000368:Aged; D000704:Analysis of Variance; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism*; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging*; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging*; D059168:Carotid Intima-Media Thickness; D015309:Glucose Clamp Technique; D006801:Humans; D007328:Insulin / Q000097:blood*; D007333:Insulin Resistance; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000175:diagnosis* / Q000000981:diagnostic imaging; D011237:Predictive Value of Tests; D012044:Regression Analysis; D015203:Reproducibility of Results; D012307:Risk Factors; D018608:Ultrasonography, Doppler
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D007328:Insulin