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- Title
Insulin Resistance and Carotid Atherosclerosis in Subjects with Type 2 Diabetes.
- Authors
Park, Seok Won; Ahn, Chul Woo; Kim, Dae Jung; Duk Song, Young; Choi, Young Ju; Huh, Byung Wook; Park, Jung Mee; Lee, Eun-Jig; Jee, Sun-Ha; Huh, Kap Bum
- Abstract
Insulin resistance (IR) may provide the crucial link between type 2 diabetes and cardiovascular disease (CVD). The associations between IR and CVD or its surrogate such as intima-media thickness (IMT) have been documented mainly in subjects with varying glucose tolerance. But, it is not well established whether IR itself confers independent association with IMT beyond known risk factors, particularly in subjects with type 2 diabetes. We examined 3,144 subjects with type 2 diabetes sequentially enrolled in Huh Diabetes Center from January 2003 to June 2006 (men: 51.4%, age: 56.8 ± 10.3 yrs). Insulin sensitivity was directly assessed by insulin tolerance test as a rate constant for plasma glucose disappearance (Kitt: %/min) after intravenous injection of regular insulin (0.1U/kg). IMT was measured at the levels of common carotid artery by a single sonographer using B-mode ultrasound. Carotid atherosclerosis was defined as having a clearly isolated focal plaque or diffuse thickening of IMT ≥ 1.1 mm. Multiple regression was used to test independent association of IR and IMT adjusting potential confounders. Carotid IMT was thicker in men and increased with increasing age, BMI, systolic blood pressure and LDL cholesterol, but decreased with increasing insulin sensitivity (Kitt), (p<0.01 for each). In multiple regression models, the association of Kitt and IMT remained significant after controlling for sex, age, BMI, systolic pressure and LDL cholesterol. One standard deviation decrease of Kitt was associated with 0.050 mm increase of carotid IMT controlling for known risk factors (p<0.001). Furthermore, the odds for carotid atherosclerosis was 1.61 (95% CI: 1.21, 2.12) in men and 2.14 (1.60, 2.86) in women with lowest quartile of Kitt (IR group) compared with men and women with highest quartile of Kitt. In conclusion, insulin resistance measured by insulin tolerance test is an independent risk factor for carotid atherosclerosis in subjects with type 2 diabetes.
- Subjects
INSULIN resistance; CAROTID artery; ATHEROSCLEROSIS; ARTERIOSCLEROSIS; PEOPLE with diabetes
- Publication
Diabetes, 2007, Vol 56, pA70
- ISSN
0012-1797
- Publication type
Article