Lack of association of insulin resistance and carotid intimal medial thickness in non‐diabetic Asian Indian subjects

Snehalatha, Chamukuttan; Vijay, V.; Mohan, Rema; Kumpatla, Satyavani; Sivasankari, S.; Megha, Tiziana; Radhika, S.; Ramachandran, Ambady

doi:10.1002/dmrr.226

Cited by 28 publications

(27 citation statements)

References 29 publications

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“…11 The finding of no association between ECAS and the apoB/apoAI ratio in this study contrasts with findings of other studies in which an increased apoB/apoAI ratio was associated with a progression in the intima-media thickness and in higher intima-media thickness values of extracranial carotid arteries. 10,20,21 This discrepancy might be attributed to ethnic differences, and, so, our findings need to be replicated in subsequent studies. One study demonstrated an ethnic difference in the association of MetS between ICAS and ECAS.…”

Section: Discussionmentioning

confidence: 72%

High Levels of Apolipoprotein B/AI Ratio Are Associated With Intracranial Atherosclerotic Stenosis

Park

Hong

Lee

et al. 2011

Stroke

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Background and Purpose-The apolipoprotein B (apoB)/apoAI ratio is recognized as a better indicator of cardiovascular disease than other cholesterol measures. Whether intracranial or extracranial atherosclerosis is more closely associated with an increased apoB/apoAI ratio has not been investigated. Methods-A total of 464 statin or fibrate naïve Korean patients with acute ischemic stroke was categorized into 3 groups:intracranial (ICAS, nϭ236), extracranial (nϭ44), and no cerebral atherosclerotic stenosis (nϭ184). The apoB/apoAI ratio and demographics, including the presence of metabolic syndrome, were compared among the groups. Results-The ICAS group showed a higher apoB/apoAI ratio (0.81Ϯ0.02) than both the extracranial atherosclerotic stenosis (0.74Ϯ0.03) and no cerebral atherosclerotic stenosis (0.72Ϯ0.02) groups (Pϭ0.002). The ratio was substantially increased (0.93Ϯ0.03) in patients with advanced ICAS (Ն3 intracranial stenoses). With a multivariable analysis, the highest apoB/apoAI ratio quartile was an independent predictor of ICAS (OR, 2.13; 95% CI, 1.05 to 4.33).A dose-response relationship was observed between the presence of advanced ICAS and the apoB/apoAI ratio quartiles (OR, 4.03; 95% CI, 1.26 to 12.88 for the second quartile; OR, 4.88; 95% CI, 1.54 to 15.49 for the third quartile; and OR, 7.79; 95% CI, 2.41 to 25.16 for the fourth quartile when referenced to the first quartile). Patients having more metabolic syndrome components were more likely to have ICAS, advanced ICAS, and a higher apoB/apoAI ratio (PϽ0.001 for all). Conclusions-A higher apoB/apoAI ratio is a predictor of ICAS rather than of extracranial atherosclerotic stenosis or no cerebral atherosclerotic stenosis. The apoB/apoAI ratio might be a biomarker for ICAS in Asian patients with stroke. (Stroke. 2011;42:3040-3046.)

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Section: Discussionmentioning

confidence: 72%

High Levels of Apolipoprotein B/AI Ratio Are Associated With Intracranial Atherosclerotic Stenosis

Park

Hong

Lee

et al. 2011

Stroke

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“…There have been several previous reports in which the association between carotid intima-media thickness and insulin resistance has been investigated in a nondiabetic population. Some studies showed a lack of independent association between insulin resistance and carotid arteriosclerosis, 9,22,23 whereas others showed a positive association between these variables. 24 Snehalatha et al 22 reported lack of an association between insulin resistance and carotid intima-media thickness in nondiabetic Asian subjects.…”

Section: Ishizaka Et Al Insulin Resistance and Atherosclerosis 297mentioning

confidence: 99%

“…Some studies showed a lack of independent association between insulin resistance and carotid arteriosclerosis, 9,22,23 whereas others showed a positive association between these variables. 24 Snehalatha et al 22 reported lack of an association between insulin resistance and carotid intima-media thickness in nondiabetic Asian subjects. Bonora et al 23 reported that carotid intima-media thickness was associated with insulin resistance in nondiabetic subjects, as determined by univariate analysis, but was not associated by multivariate analysis, although their number of enrolled subjects (nϭ58) was relatively small.…”

Section: Ishizaka Et Al Insulin Resistance and Atherosclerosis 297mentioning

confidence: 99%

Association Between Insulin Resistance and Carotid Arteriosclerosis in Subjects With Normal Fasting Glucose and Normal Glucose Tolerance

Ishizaka

Takahashi

et al. 2003

ATVB

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Objective-We examined the possible association between insulin resistance and carotid arteriosclerosis in subjects who had both normal fasting glucose and normal glucose tolerance after intake of a glucose load. Methods and Results-Our subjects were individuals who underwent general health screening at our institute, which included carotid ultrasound and oral glucose tolerance testing. Of the 1238 subjects enrolled in our study, 738 (60%) were classified as normal, defined as a normal fasting glucose level and normal glucose tolerance, and 334 (27%) and 166 (13%) were classified as borderline and diabetic, respectively, according to the criteria of the Japan Diabetes Society. The homeostasis model assessment of insulin resistance (HOMA-IR) was used as the index to measure insulin resistance. In normal-type subjects, univariate analysis showed that insulin resistance, but not insulin secretion, was associated with the presence of carotid plaque. Multivariate analysis showed that HOMA-IR was positively associated with carotid plaque in normal-type subjects, with an odds ratio of 1.19 (95% confidence interval, 1.00 to 1.41; PϽ0.05). Conclusions-These data suggest the possibility that the presence of higher insulin resistance could be a risk factor for carotid arteriosclerosis in subjects with normal fasting glucose and normal glucose tolerance.

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“…Several studies found that the inverse correlation of CA-IMT with insulin resistance was no longer significant after adjustment for established risk factors in multivariate analysis in studies using the index of fasting proinsulin (12), HOMA-IR (15), KITT (14), FSIVGTT (11), or euglycemic clamp (13) as indices. Recent studies failed to find significant associations of CA-IMT with insulin resistance assessed by HOMA-IR (16) or SSPG (17). To our knowledge, only two studies have found a lack of a significant association of FA-IMT with insulin resistance assessed by FSIVGTT (21) or euglycemic clamp (13) in healthy subjects, and there are no such findings for type 2 diabetes.…”

Section: Discussionmentioning

confidence: 77%

“…The study by Laakso et al was the first to show reduced insulin sensitivity by euglycemic hyperinsulinemic clamp in nonobese, nondiabetic subjects with asymptomatic atherosclerosis, along with increased intimal-medial thickness (IMT), compared with control subjects (6). Subsequent studies mainly in non-diabetic subjects including those with hypertension or angina demonstrated complex outcomes concerning the association of IMT of the carotid artery with insulin resistance; significant (7)(8)(9)(10), partially significant, that is, significant in univariate but not in multivariate analysis (11)(12)(13)(14)(15), or nonsignificant (16,17). In type 2 diabetic patients, two studies found an inverse association of IMT of carotid artery with insulin resistance (18,19), but another did not (20).…”

Section: Introductionmentioning

confidence: 99%

Arterial Wall Thickness is Associated with Insulin Resistance in Type 2 Diabetic Patients

Fujiwara

Emoto

Komatsu

et al. 2003

J Atheroscler Thromb

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The aim of the present study was to investigate the independent association of the intimal-medial thickness of carotid and femoral arteries (CA-IMT and FA-IMT), a marker of atheroscelosis, with insulin resistance in type 2 diabetic patients. We evaluated CA-IMT and FA-IMT by high-resolution ultrasonography and insulin resistance determined by euglycemic hyperinsulinemic clamp in 119 type 2 diabetic subjects, 71 males and 48 females (

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Lack of association of insulin resistance and carotid intimal medial thickness in non‐diabetic Asian Indian subjects

Abstract: In southern Indians, IGT did not influence the IMT. Although insulin resistance was higher in IGT, it was not associated with higher IMT. Conventional risk factors such as cholesterol, LDL-cholesterol and apolipoproteins showed association with IMT in the insulin-resistant population.

Cited by 28 publications

References 29 publications

High Levels of Apolipoprotein B/AI Ratio Are Associated With Intracranial Atherosclerotic Stenosis

High Levels of Apolipoprotein B/AI Ratio Are Associated With Intracranial Atherosclerotic Stenosis

Association Between Insulin Resistance and Carotid Arteriosclerosis in Subjects With Normal Fasting Glucose and Normal Glucose Tolerance

Arterial Wall Thickness is Associated with Insulin Resistance in Type 2 Diabetic Patients

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