Background: Glucose, insulin and Homeostasis Model Assessment Insulin Resistance (HOMA-IR) are markers of insulin resistance. The objective of this study is to compare fasting glucose, fasting insulin concentrations and HOMA-IR in strength of association with incident cardiovascular disease.
Methods: We searched the PubMed, MEDLINE, EMBASE, Web of Science, ScienceDirect and Cochrane Library databases from inception to March, 2011, and screened reference lists. Cohort studies or nested case-control studies that investigated the association between fasting glucose, fasting insulin or HOMA-IR and incident cardiovascular disease, were eligible. Two investigators independently performed the article selection, data extraction and risk of bias assessment. Cardiovascular endpoints were coronary heart disease (CHD), stroke or combined cardiovascular disease. We used fixed and random-effect meta-analyses to calculate the pooled relative risk for CHD, stroke and combined cardiovascular disease, comparing high to low concentrations of glucose, insulin or HOMA-IR. Study heterogeneity was calculated with the I(2) statistic. To enable a comparison between cardiovascular disease risks for glucose, insulin and HOMA-IR, we calculated pooled relative risks per increase of one standard deviation.
Results: We included 65 studies (involving 516,325 participants) in this meta-analysis. In a random-effect meta-analysis the pooled relative risk of CHD (95% CI; I(2)) comparing high to low concentrations was 1.52 (1.31, 1.76; 62.4%) for glucose, 1.12 (0.92, 1.37; 41.0%) for insulin and 1.64 (1.35, 2.00; 0%) for HOMA-IR. The pooled relative risk of CHD per one standard deviation increase was 1.21 (1.13, 1.30; 64.9%) for glucose, 1.04 (0.96, 1.12; 43.0%) for insulin and 1.46 (1.26, 1.69; 0.0%) for HOMA-IR.
Conclusions: The relative risk of cardiovascular disease was higher for an increase of one standard deviation in HOMA-IR compared to an increase of one standard deviation in fasting glucose or fasting insulin concentration. It may be useful to add HOMA-IR to a cardiovascular risk prediction model.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3532497 | PMC |
| http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0052036 | PLOS |
Publication Analysis
Top Keywords
Similar Publications
The adapted Caprini score as a proxy forpostoperative venous thromboembolismprophylaxis: a tertiary hospital experience.
S Afr J Surg
December 2024
Department of Biostatistics, Faculty of Health Sciences, University of the Free State, South Africa.
Background: Postoperative patients' risk for developing venous thromboembolism (VTE) can be predicted using the adapted Caprini risk assessment model which informs administration of postoperative VTE prophylaxis. The study aimed to assess the appropriateness of postoperative VTE prophylaxis of patients according to the adapted Caprini scores and investigate whether a patient's HIV status influenced postoperative VTE prophylaxis administration.
Methods: This cohort study included patients who had elective or urgent surgery at a tertiary hospital, Bloemfontein.
Experience of a tertiary/quaternary unit with surgery for endocrine hypertension.
S Afr J Surg
December 2024
Department of Surgery, School of Clinical Medicine, Chris Hani Baragwanath Academic Hospital, University of the Witwatersrand, South Africa.
Background: Endocrine hypertension is believed to be underestimated worldwide especially in the developing countries. There is a scarcity of publications on endocrine hypertension in sub-Saharan Africa. The aim of this study was to reflect the profile of patients with endocrine hypertension of adrenal/paraganglioma origin at Chris Hani Baragwanath Academic Hospital (CHBAH).
View Article and Find Full Text PDFLong-Term Blood Pressure Trends After a Remote Hypertension Intervention: A Secondary Analysis of the Digital Care Transformation: Remotely Delivered Hypertension Management Program.
Hypertension
January 2025
Accelerator for Clinical Transformation, Brigham and Women's Hospital, Boston, MA. (S.H., A.J.B., D.Z., S.K., K.W., D.G., C.P.C., B.M.S.).
Background: Hypertension is a major cardiovascular risk factor, yet traditional care often results in suboptimal blood pressure (BP) control at the population level. We implemented a remote hypertension management program that monitored home BP and titrated medications per algorithm. This study assessed the program's long-term effects by examining participants' office BP up to 42 months post-enrollment.
View Article and Find Full Text PDFPreservation of Vascular Endothelial Function in Late-Onset Postmenopausal Women.
Circ Res
January 2025
Department of Integrative Physiology, University of Colorado Boulder (S.D., K.O.M., K.R.L., K.H.A., D.H.C., K.A.F., D.R.S., M.J.R.).
Background: Postmenopausal women (PMW) who complete menopause at a late age (55+ years) have lower cardiovascular disease risk than PMW who complete menopause at a normal age (45-54 years). However, the influence of late-onset menopause on vascular endothelial dysfunction is unknown. Moreover, the mechanisms by which a later age at menopause may modulate endothelial function remain to be determined.
View Article and Find Full Text PDFLong-Term Prognostic Implications of Non-Culprit Lesions in Patients Presenting With an Acute Myocardial Infarction: Is It the Angiographic Stenosis Severity or the Underlying High-Risk Morphology?
Circulation
January 2025
Department of Cardiology, The 2nd Affiliated Hospital of Harbin Medical University, Harbin, China (J.D., J.Z., X.X., Y.C., S.S., S.L., L.C., Y.W., L.L., R.G., D.H., X.M., R.Z., H.Y., T.C., J.T., X.L., S.J., J.H., C.F.B.Y.).
Background: Patients with acute myocardial infarction and angiographically obstructive non-culprit lesions are at high risk for recurrent major adverse cardiac events (MACEs). However, it remains largely unknown whether events are due to stenosis severity or due to the underlying high-risk lesion morphology.
Methods: Between January 2017 and December 2021, 1312 patients with acute myocardial infarction underwent optical coherence tomography of all the 3 main epicardial arteries after successful percutaneous coronary intervention.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!