title: Sex-specific relations between fasting insulin, insulin resistance and incident hypertension: 8.9 years follow-up in a Middle-Eastern population.
abstract: The purpose of this study was to investigate whether fasting serum insulin levels, homeostasis model assessment of insulin resistance (HOMA-IR) and insulin-to-glucose ratio (IGR) were associated with incident hypertension. In a prospective study, 4093 Iranian participants (1725 men and 2368 women) without hypertension and known diabetes at baseline (1999-2001) were followed for a median of 8.9 years. Regular follow-up examinations were performed at 3-year intervals. Multivariate Cox proportional hazard models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) of incident hypertension adjusting for sex, and in sex-stratified models. During the study, 896 incident cases of hypertension (432 men and 464 women) were identified (total incident rate: 27.5 per 1000 person-years). In the multivariable models, serum insulin level, HOMA-IR and IGR were positively associated with hypertension incidence, adjusting for sex. In the sex-stratified analyses, after adjusting for potential confounders, women in the highest quartile of insulin, HOMA-IR and IG had a significantly higher incidence of hypertension, compared with those in the lowest quartile (HR: 1.7 (95% CI 1.26-2.30); HR: 1.80 (95% CI 1.31-2.40) and HR: 1.67 (95% CI 1.26-2.22), respectively); among men, these relations were also significant, until including waist circumference and body mass index in the models (HR: 1.17 (95% CI 0.85-1.62), HR: 1.25 (95% CI 0.91-1.73) and HR: 1.06 (95% CI 0.77-1.45), respectively). Higher fasting serum insulin levels, HOMA-IR and IGR were associated with incident hypertension among women, whereas these associations were not significant after adjusting for obesity measures in men.
authors.affiliation: Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran.
authors.forename: B
authors.initials: B
authors.lastname: Arshi
authors.affiliation: Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran.
authors.forename: M
authors.initials: M
authors.lastname: Tohidi
authors.affiliation: Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran.
authors.forename: A
authors.initials: A
authors.lastname: Derakhshan
authors.affiliation: Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran.
authors.forename: S
authors.initials: S
authors.lastname: Asgari
authors.affiliation: Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran.
authors.forename: F
authors.initials: F
authors.lastname: Azizi
authors.affiliation: Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran.
authors.forename: F
authors.initials: F
authors.lastname: Hadaegh
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure; D005215:Fasting / Q000097:blood*; D005260:Female; D005500:Follow-Up Studies; D054624:Health Status Disparities; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D015994:Incidence; D007328:Insulin / Q000097:blood*; D007333:Insulin Resistance; D007492:Iran / Q000453:epidemiology; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D012737:Sex Factors; D013997:Time Factors; D055815:Young Adult
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D007328:Insulin