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Risk factor groupings related to insulin resistance and their synergistic effects on subclinical atherosclerosis: the atherosclerosis risk in communities study.

TitleRisk factor groupings related to insulin resistance and their synergistic effects on subclinical atherosclerosis: the atherosclerosis risk in communities study.
Publication TypeJournal Article
Year of Publication2002
AuthorsGolden S H, Folsom AR, Coresh J, A Sharrett R, Szklo M, Brancati F
JournalDiabetes
Volume51
Issue10
Pagination3069-76
Date Published2002 Oct
ISSN0012-1797
KeywordsCarotid Artery Diseases, Cholesterol, HDL, Cohort Studies, Diabetes Mellitus, Female, Humans, Hyperglycemia, Hyperinsulinism, Hypertension, Hypertriglyceridemia, Insulin Resistance, Male, Middle Aged, Multivariate Analysis, Obesity, Risk Factors, Tunica Intima
Abstract

The extent to which groupings of insulin resistance-related cardiovascular risk factors synergize to produce atherosclerosis beyond what is expected from their additive effects is uncertain. The objective of this study was to measure interactions among groupings of the features of the insulin resistance syndrome (IRS) on carotid intimal-medial thickness (IMT). This cross-sectional study used baseline data from the Atherosclerosis Risk in Communities Study on 11,790 adults aged 45-64 years without diagnosed diabetes, treated dyslipidemia, or coronary heart disease. The main outcome was carotid IMT, assessed using B-mode ultrasound. The excess carotid IMT attributable to each IRS grouping was determined using multiple linear regression models. There were 57 possible combinations of six IRS components (hypertension, hyperinsulinemia, obesity, hypertriglyceridemia, low HDL cholesterol, and hyperglycemia). In multivariate analysis, 29 of the 57 groupings were associated with excess carotid IMT. Individuals with all six IRS components had the greatest excess IMT compared with those without this grouping (71 micro m; 95% CI 40-102 micro m). The groupings most strongly associated with excess carotid IMT included hypertension and hypertriglyceridemia. Interventions aimed at ameliorating the IRS may produce reductions in atherosclerotic risk beyond that predicted by treatment of individual IRS-related risk factors.

DOI10.2337/diabetes.51.10.3069
Alternate JournalDiabetes
PubMed ID12351449
Grant ListN01 HC55015 / HC / NHLBI NIH HHS / United States
N01 HC55016 / HC / NHLBI NIH HHS / United States
N01 HC55018 / HC / NHLBI NIH HHS / United States
N01 HC55019 / HC / NHLBI NIH HHS / United States
N01 HC55020 / HC / NHLBI NIH HHS / United States
N01 HC55021 / HC / NHLBI NIH HHS / United States
N01 HC55022 / HC / NHLBI NIH HHS / United States
T32HL07024 / HL / NHLBI NIH HHS / United States