The Association between Insulin Resistance and Cardiovascular Disease Risk: A Community-Based Cross-Sectional Study among Taiwanese People Aged over 50 Years

Abstract

Background and Aims: Previous studies have implied that insulin resistance (IR) could represent a major underlying abnormality leading to cardiovascular disease (CVD). The aim of this study was to evaluate the relationships between IR (estimated by the homeostasis model assessment of IR (HOMA-IR) index) and CVD risk among middle-aged and elderly Taiwanese individuals. Methods: In this cross-sectional, community-based study, a total of 320 participants were interviewed to collect demographical parameters and blood samples. The recruited participants were divided into tertiles according to their levels of HOMA-IR. The Framingham risk score (FRS) was calculated according to the 2008 general CVD risk model from the Framingham Heart Study. Results: The HOMA-IR index was significantly correlated with the FRS, with a Pearson’s coefficient of 0.22. In the multiple logistic regression model, a higher HOMA-IR level was significantly associated with a high FRS (FRS ≥ 20%) (highest tertile vs. lowest tertile of HOMA-IR, crude OR = 3.69; 95% CI = 1.79–7.62), even after adjusting for smoking, fasting plasma glucose (FPG), and systolic blood pressure (SBP) (highest tertile vs. lowest tertile of HOMA-IR, adjusted OR = 11.51; 95% CI = 2.55–51.94). The area under the receiver operating characteristic curve for the HOMA-IR index as the predictor of high FRS was 0.627, and the optimal HOMA-IR cutoff value was 1.215 (sensitivity = 83.6%, specificity = 42.9%). Conclusions: We considered that HOMA-IR is an independent factor but that it cannot be used solely for evaluating the CVD risk due to the low AUC value. Further prospective cohort studies are warranted to better assess the relationship between CVD risk and insulin resistance.

Effects of Combined High-Protein Diet and Exercise Intervention on Cardiometabolic Health in Middle-Aged Obese Adults: A Randomized Controlled Trial

“…Glucose homeostasis is a key marker of cardiometabolic health of individuals (36). We found that fasting glucose levels, fasting insulin levels, and AUCs of glucose and insulin were similar among groups after intervention (p > 0.05).…”

Red Yeast Rice Preparations Reduce Mortality, Major Cardiovascular Adverse Events, and Risk Factors for Metabolic Syndrome: A Systematic Review and Meta−analysis

“…Blood glucose parameters are related to diabetes. A recent nationwide epidemiological data demonstrated that elevated FPG increase the risk of CVD ( Kaneko et al, 2021 ); each 1% higher HbA1c, independent of diabetes status, is associated with an 18% greater risk of myocardial infarction ( de Jong et al, 2020 ); HOMA−IR is positive correlation with CVD risk ( Lu et al, 2020 ). This meta−analysis observed that RYR preparations significantly reduced the levels of FPG, HbA1c and HOMA−IR, indicating its promising application in improving diabetes and CVD.…”

Differences in the impact of impaired glucose status on clinical outcomes in younger and older adults: Over a decade of follow-up in the Tehran lipid and glucose study

“…Data from the Prospective Study of Pravastatin in the Elderly at Risk (PROSPER) cohort showed that insulin and HOMA-IR are not associated with an increased risk of incident CVD in elderly people without diabetes ( 37 ). In another study conducted by Lu et.al ( 38 ), the association between HOAMA-IR and a person's risk of CVD using the Framingham risk score (FRS) was evaluated by Taiwanese people aged ≥50 years. They found that HOMA-IR >1.15 were significantly associated with a high level of FRS (≥ 20%) but it is not recommended to use solely for evaluating the CVD risk because of the low level of the areas under the curve (0.627).…”