title: IGF-1 and Insulin Resistance Are Major Determinants of Common Carotid Artery Thickness in Morbidly Obese Young Patients.
abstract: We assessed the relationship between insulin resistance, serum insulin-like growth factor 1 (IGF-1) levels, and common carotid intima-media thickness (CC-IMT) in morbidly obese young patients. A total of 249 patients (aged 37.9 ± 9.8 years, body mass index [BMI] 45.6 ± 8.3 kg/m(2)) were evaluated (metabolic tests, serum IGF-1 measurements, homeostasis model assessment-insulin resistance [HOMA-IR], and ultrasonographically assessed CC-IMT) in a research program for bariatric surgery candidates. After adjusting for age, gender, BMI, systolic blood pressure, uric acid, antihypertensive and lipid-lowering treatment, metabolic syndrome, and metabolic class, both HOMA-IR and IGF-1 z-score were significantly associated with CC-IMT. These results were confirmed in logistic regression analysis, in which age (β = 1.11, P = .001), gender (β = 3.19, P = .001), HOMA-IR (β = 1.221, P = .005), and IGF-1 z-score (β = 1.734, P = .009) were the only independent determinants of abnormal CC-IMT, presumably modulating the effect of the other risk factors included in the regression. Area under the receiver-operating characteristic curve for the model was 0.841 (confidence interval: 0.776-0.907; P < .001). In conclusion, in morbidly obese young adults, insulin resistance and IGF-1 z-score are significantly associated with CC-IMT, independent of other major cardiovascular risk factors.
authors.affiliation: Endocrinology Department, Elias University Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania Victor Babes Institute, Bucharest, Romania.
authors.forename: Anca
authors.initials: A
authors.lastname: Sirbu
authors.affiliation: Neurology Department, Elias University Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.
authors.forename: Horia
authors.initials: H
authors.lastname: Nicolae
authors.affiliation: Endocrinology Department, Elias University Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.
authors.forename: Sorina
authors.initials: S
authors.lastname: Martin
authors.affiliation: Endocrinology Department, Elias University Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.
authors.forename: Carmen
authors.initials: C
authors.lastname: Barbu
authors.affiliation: Ponderas Hospital, Bucharest, Romania.
authors.forename: Catalin
authors.initials: C
authors.lastname: Copaescu
authors.affiliation: Endocrinology Department, Elias University Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.
authors.forename: Suzana
authors.initials: S
authors.lastname: Florea
authors.affiliation: Neurology Department, Elias University Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.
authors.forename: Cristina
authors.initials: C
authors.lastname: Panea
authors.affiliation: Endocrinology Department, Elias University Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania simonafica@yahoo.com.
authors.forename: Simona
authors.initials: S
authors.lastname: Fica
mesh_terms: D000328:Adult; D000367:Age Factors; D019540:Area Under Curve; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000032:analysis; D015992:Body Mass Index; D002340:Carotid Artery Diseases / Q000097:blood / Q000000981:diagnostic imaging / Q000209:etiology*; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging*; D059168:Carotid Intima-Media Thickness; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D007334:Insulin-Like Growth Factor I / Q000032:analysis*; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000097:blood / Q000150:complications* / Q000175:diagnosis; D011237:Predictive Value of Tests; D012372:ROC Curve; D018570:Risk Assessment; D012307:Risk Factors
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; C583557:IGF1 protein, human; D007328:Insulin; D007334:Insulin-Like Growth Factor I
keywords: IGF-1; IMT; atherosclerosis; insulin resistance; morbid obesity