title: Association between HOMA-IR, fasting insulin and fasting glucose with coronary heart disease mortality in nondiabetic men: a 20-year observational study.
abstract: Whether glucose and insulin are differently associated with the risk of coronary heart disease (CHD) mortality is unclear. We aimed to estimate the association between insulin resistance (estimated by the homeostasis model assessment for insulin resistance, HOMA-IR), fasting serum insulin (FI) and fasting plasma glucose (FPG) with incident CHD mortality in a prospective study including middle-aged nondiabetic Finnish men. During an average follow-up of 20 years, 273 (11 %) CHD deaths occurred. In a multivariable Cox regression analysis adjusted for age, body mass index, systolic blood pressure, serum LDL-cholesterol, cigarette smoking, history of CHD, alcohol consumption, blood leukocytes and plasma fibrinogen, the hazard ratios (HRs) for CHD mortality comparing top versus bottom quartiles were as follows: 1.69 (95 % CI: 1.15-2.48; p = 0.008) for HOMA-IR; 1.59 (1.09-2.32; p = 0.016) for FI; and 1.26 (0.90-1.76; p = 0.173) for FPG. These findings suggest that IR and FI, but not FPG, are independent risk factors for CHD mortality. Further studies could help clarify these results in terms of screening and risk stratification, causality of the associations, and therapeutical implications.
authors: Institute of Public Health, School of Public Health and Clinical Nutrition, University of Eastern Finland, P.O. Box 1627, 70211, Kuopio, Finland, sudhir.kurl@uef.fi.
authors: Sudhir
authors: S
authors: Kurl
authors: Francesco
authors: F
authors: Zaccardi
authors: Vivian N
authors: VN
authors: Onaemo
authors: Sae Young
authors: SY
authors: Jae
authors: Jussi
authors: J
authors: Kauhanen
authors: Kimmo
authors: K
authors: Ronkainen
authors: Jari A
authors: JA
authors: Laukkanen
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000378:metabolism*; D001794:Blood Pressure; D015992:Body Mass Index; D003327:Coronary Disease / Q000097:blood / Q000453:epidemiology / Q000401:mortality* / Q000503:physiopathology; D005215:Fasting / Q000097:blood*; D005387:Finland / Q000453:epidemiology; D005500:Follow-Up Studies; D006801:Humans; D007328:Insulin / Q000097:blood*; D007333:Insulin Resistance; D008297:Male; D011446:Prospective Studies
chemical_list: D001786:Blood Glucose; D007328:Insulin