The Risk for Coronary Heart Disease According to Insulin Resistance with and without Type 2 Diabetes. (November 2013)

• Record Type: Journal Article
• Authors: Kim, Jongoh; Chae, Young Kwang; Chernoff, Arthur
• Is Part Of: Endocrine research. Volume 38:Number 4(2013:Nov.)
• Page Start: 195
• Page End: 205
• Publication Date: 2013-11
• Subjects: Endocrinology, Experimental -- Periodicals; Endocrinology -- Periodicals; Endocrinology -- Periodicals; Research -- Periodicals; 616.4
• DOI: 10.3109/07435800.2013.766800
• Languages: English
• ISSNs: 0743-5800

Abstract

<abstract> <title> <x xml:space="preserve">Abstract</x> </title> <p> <italic>Objective</italic>. To examine the role of insulin resistance versus hyperglycemia in the risk for coronary heart disease (CHD) and to explore the interaction of insulin resistance with hyperglycemia. <italic>Methods</italic>. This is a cross-sectional study based on the National Health and Nutrition Examination Survey III (NHANES). 4, 825 subjects were selected from 9, 737 adults aged <sup>3</sup>40 years excluding those with fasting <8 hours, type 1 diabetes, pregnancy, or missing data. Insulin resistance was calculated using the HOMA II and then log-transformed (log IR). Odds ratios (OR) of CHD was obtained with multiple logistic regression with reference to non-diabetics with log IR > 1. <italic>Results</italic>. CHD and type 2 diabetes were present in 9.1 % and 10.5%. Elevated insulin resistance was common; diabetics and non-diabetics with log IR > 1 constituted 6.3% and 12.1% of the population, respectively. ORs for CHD increased as insulin resistance increased in both non-diabetic and diabetics. When log IR > 1, the risk for CHD was not different between diabetics and non-diabetics (OR 1.12, 95% CI; 0.76–1.65). Furthermore, the risk for CHD was higher in non-diabetics with log IR > 1 than in diabetics with log IR1 (OR 0.55, 95% CI; 0.36–0.85). <italic>Conclusions</italic>. Insulin resistance was a greater risk for CHD than type 2 diabetes. Non-diabetics can have a higher risk for CHD than diabetics when insulin resistance is elevated. More research is warranted to develop strategies to identify and treat insulin resistance.</p> </abstract>