title: Relationship between insulin resistance and subclinical atherosclerosis in individuals with and without type 2 diabetes mellitus.
abstract: BACKGROUND
  Insulin resistance is of utmost importance as an underlying mechanism for increased risk of cardiovascular disease (CVD). We assessed the association between Homeostatic Model Assessment (HOMA-IR) and two surrogate subclinical atherosclerosis markers (SCA) among individuals with and without type 2 diabetes (DM), those who did not have any clinical presentation of the CVD.
  
  
  METHODS
  In a cross-sectional study, 208 participants (105 diabetics and 103 non-diabetics) were enrolled from referred patients with diabetes to an academic outpatient clinic and their non-diabetic relatives in-law. Fasting serum levels of insulin, blood glucose and lipid profile, were measured. Anthropometric and blood pressure were measuremented standardly. Body Mass Index (BMI) and Homeostatic Model Assessment-Insulin Resistance (HOMA-IR) index were calculated. Coronary Artery Calcium Score(CACS) was measured using a Multi-Detctor CT scanner. Flow mediated dilation (FMD) was measured using bimode ultrasonography (with linear transducer 13,000 MHZ). Univariate and multivariate logistic regression models were used to evaluate the association between these SCA markers and HOMA index in adjusting models.
  
  
  RESULTS
  CACS and HOMA-IR were higher and FMD was lower in diabetic participants than non-diabetic ones (P< 0.01) In a stepwise logistic regression model, CACS and FMD were associated with HOMA-IR (odds ratio = 1.778; 95 % confidence interval (CI): 1.211-2.726 and odds ratio = 1.557; 95 % CI: 1.601-2.275, respectively) in non-diabetics but not among diabetic participants.
  
  
  CONCLUSIONS
  CACS and FMD are related to insulin resistance among non-diabetic individuals, but we could not find this relationship among diabetic patients.
authors.affiliation: Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Fourth Floor, No 4th, Ostad Nejatollahi Street, Enghelab Avenue, Tehran, 15996615 Iran.
authors.forename: Hossein
authors.initials: H
authors.lastname: Fakhrzadeh
authors.affiliation: Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Fourth Floor, No 4th, Ostad Nejatollahi Street, Enghelab Avenue, Tehran, 15996615 Iran.
authors.forename: Farshad
authors.initials: F
authors.lastname: Sharifi
authors.affiliation: Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Fourth Floor, No 4th, Ostad Nejatollahi Street, Enghelab Avenue, Tehran, 15996615 Iran.
authors.forename: Mahtab
authors.initials: M
authors.lastname: Alizadeh
authors.affiliation: Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Fourth Floor, No 4th, Ostad Nejatollahi Street, Enghelab Avenue, Tehran, 15996615 Iran.
authors.forename: Seyed Masoud
authors.initials: SM
authors.lastname: Arzaghi
authors.affiliation: Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Fourth Floor, No 4th, Ostad Nejatollahi Street, Enghelab Avenue, Tehran, 15996615 Iran.
authors.forename: Yaser
authors.initials: Y
authors.lastname: Tajallizade-Khoob
authors.affiliation: Endocrinology and Metabolism Research Center, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Tootee
authors.affiliation: Endocrinology and Metabolism Research Center, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Sudabeh
authors.initials: S
authors.lastname: Alatab
authors.affiliation: Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Fourth Floor, No 4th, Ostad Nejatollahi Street, Enghelab Avenue, Tehran, 15996615 Iran.
authors.forename: Mojde
authors.initials: M
authors.lastname: Mirarefin
authors.affiliation: Endocrinology and Metabolism Research Center, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Zohre
authors.initials: Z
authors.lastname: Badamchizade
authors.affiliation: Pediatrics, Shahed University, Faculty of Medicine, Tehran, Iran.
authors.forename: Hadi
authors.initials: H
authors.lastname: Kazemi
keywords: Atherosclerosis; Cardiovascular diseases; Coronary artery calcium score (CACS); Diabetes mellitus; Flow mediated dilation (FMD); HOMA-IR; Insulin resistance