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- Title
Fasting insulin, insulin resistance, and risk of cardiovascular or all-cause mortality in non-diabetic adults: a meta-analysis.
- Authors
Xiaohong Zhang; Jun Li; Shuiping Zheng; Qiuyun Luo; Chunmei Zhou; Chaoyang Wang
- Abstract
Studies on elevated fasting insulin or insulin resistance (IR) and cardiovascular or all-cause mortality risk in non-diabetic individuals have yielded conflicting results. This meta-analysis aimed to evaluate the association of elevated fasting insulin levels or IR as defined by homeostasis model assessment of IR (HOMA-IR) with cardiovascular or all-cause mortality in non-diabetic adults. We searched for relevant studies in PubMed and Emabse databases until November 2016. Only prospective observational studies investigating the association of elevated fasting insulin levels or HOMA-IR with cardiovascular or all-cause mortality risk in non-diabetic adults were included. Risk ratio (RR) with its 95% confidence intervals (CIs) was pooled for the highest compared with the lowest category of fasting insulin levels or HOMA-IR. Seven articles involving 26976 non-diabetic adults were included. The pooled, adjusted RR of all-cause mortality comparing the highest with the lowest category was 1.13 (95% CI: 1.00-1.27; P=0.058) for fasting insulin levels and 1.34 (95% CI: 1.11-1.62; P=0.002) for HOMA-IR, respectively. When comparing the highest with the lowest category, the pooled adjusted RR of cardiovascular mortality was 2.11 (95% CI: 1.01-4.41; P=0.048) for HOMA-IR in two studies and 1.40 (95% CI: 0.49-3.96; P=0.526) for fasting insulin levels in one study. IR as measured by HOMA-IR but not fasting insulin appears to be independently associated with greater risk of cardiovascular or all-cause mortality in non-diabetic adults. However, the association of fasting insulin and HOMA-IR with cardiovascular mortality may be unreliable due to the small number of articles included.
- Subjects
CARDIOVASCULAR disease related mortality; INSULIN resistance; PEOPLE with diabetes; FASTING; HEALTH of adults; PHYSIOLOGY
- Publication
Bioscience Reports, 2017, Vol 37, Issue 5, p1
- ISSN
0144-8463
- Publication type
Article
- DOI
10.1042/BSR20170947