title: The predictive relationship between baseline insulin and glucose with subclinical carotid atherosclerosis after 5 years in a multi-ethnic cohort.
abstract: We aimed at exploring the relationship between baseline insulin and glucose and the progression of carotid atherosclerosis in a multi-ethnic cohort.
  
  
  
  Males and females (n = 797) of European, Chinese, South Asian and Aboriginal origin were assessed as part of the Multicultural Community Health Assessment Trial (MCHAT) study for socio-demographics, smoking status, fasting insulin and glucose at baseline. IMT, plaque area and total area were assessed after 5 years.
  
  
  
  A total of 545 participants returned after 5 years for a follow-up assessment. Average age of the study participants was 47.5 (SD 8.9) years. At baseline, the median and interquartile range for insulin was 62.0 (49.5) pmol/L, and glucose was 5.2 (0.60) mmol/L. Baseline glucose and insulin predicted the 5-year progression of atherosclerosis in our models, after adjusting for covariates. We found significant insulin-ethnicity interactions in the IMT model (p = 0.044) with the slope of the relationship showing that for every percentage change in insulin the Europeans experienced 7.3% more increase in IMT at 5 years than the Aboriginals. In the plaque area and total area models, there were significant glucose-ethnicity interactions (p = 0.009 and p=0.016 respectively), with the slope showing a 101% and 121% increase for plaque area and total area, respectively, in Europeans, at 5 years per percent change in glucose at baseline. Logistic regression found a significant glucose-ethnicity interaction with the presence of plaques (OR = 0.31, p = 0.03) such that compared to the Europeans, the South Asians had a lower odds of developing plaque presence. Similarly, we found glucose-ethnicity interactions in the logistic regression when comparing the Chinese to the Europeans (OR = 0.2, p=0.005), with the Chinese being less likely to develop plaque presence.
  
  
  
  Ethnicity modifies the predictive relationship between insulin and glucose with sub-clinical indicators of carotid atherosclerosis but not consistently so.
authors.affiliation: Department of Biomedical Physiology and Kinesiology, Simon Fraser University, V6B 5K3 Vancouver, BC, Canada.
authors.forename: Adeleke O
authors.initials: AO
authors.lastname: Fowokan
authors.affiliation: Department of Biomedical Physiology and Kinesiology, Simon Fraser University, V6B 5K3 Vancouver, BC, Canada.
authors.forename: Iris A
authors.initials: IA
authors.lastname: Lesser
authors.affiliation: Division of Cardiology, University of British Columbia, Vancouver, BC, Canada.
authors.forename: Karin H
authors.initials: KH
authors.lastname: Humphries
authors.affiliation: UBC Division of Cardiology, Department of Medicine, University of British Columbia, V5Z 1M9 Vancouver, BC, Canada.
authors.forename: John G B
authors.initials: JG
authors.lastname: Mancini
authors.affiliation: Department of Biomedical Physiology and Kinesiology, Simon Fraser University, V6B 5K3 Vancouver, BC, Canada; Faculty of Health Sciences, Simon Fraser University, V5A 1S6 Burnaby, BC, Canada; Division of Cardiology, Providence Health Care, V6Z 1Y6 Vancouver, BC, Canada. Electronic address: slear@providencehealth.bc.ca.
authors.forename: Scott A
authors.initials: SA
authors.lastname: Lear
mesh_terms: D000328:Adult; D044467:American Indian or Alaska Native; D044466:Asian People; D058070:Asymptomatic Diseases; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism*; D002170:Canada / Q000453:epidemiology; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging / Q000208:ethnology*; D059168:Carotid Intima-Media Thickness; D016009:Chi-Square Distribution; D002681:China / Q000208:ethnology; D018450:Disease Progression; D005260:Female; D006801:Humans; D007328:Insulin / Q000097:blood*; D016014:Linear Models; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011379:Prognosis; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D044465:White People
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D007328:Insulin
keywords: Atherosclerosis; Carotid ultrasound; Epidemiology; Ethnicity; Glucose; Insulin