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Insulin resistance is associated with increased cardiovascular risk in Asian Indians with normal glucose tolerance--the Chennai Urban Rural Epidemiology Study (CURES-66).
J Assoc Physicians India. 2011 Aug; 59:480-4.JA

Abstract

OBJECTIVE

The aim of the study was to assess the association of Insulin Resistance [IR] assessed by Homeostasis Assessment model (HOMA-IR) with cardiovascular risk factors in subjects with Normal Glucose Tolerance [NGT] in Asian Indians.

METHODS

This cross-sectional study recruited subjects from the Chennai Urban Rural Epidemiology Study [CURES] an epidemiological study in a representative population of Chennai [formerly Madras], in South India. We included 1550 subjects with normal glucose tolerance, ie, fasting plasma glucose < 100 mg/dl [5.6 mmol/L] and 2 hour post load plasma glucose < 140 mg/dl [7.8 mmol/L]. IR was calculated using the homeostasis assessment model (HOMA-IR) using the formula: fasting insulin (1IU/mL) fasting glucose (mmol/L)/22.5. Metabolic syndrome [MS] was defined based on modified Adult Treatment Panel III (ATP III) guidelines.

RESULTS

HOMA-IR was found to be significantly associated with systolic blood pressure (beta = 0.100, p < 0.001), diastolic pressure (beta = 0.094, p < 0.001), total cholesterol (beta = 0.068, p = 0.005), serum triglycerides (beta = 0.105, p < 0.001), LDL cholesterol (beta = 0.118, p < 0.005), and HDL cholesterol (beta = -0.060, p < 0.001) even after adjusting age, gender and BMI. Subjects with family history of type 2 diabetes had significantly higher HOMA-IR [p = 0.011] compared to those without family history. In relation to physical activity, subjects with heavy grade activity had significantly lower HOMA-IR values compared to the light grade activity [p < 0.001] Subjects with generalized obesity [p < 0.001] and abdominal obesity [p < 0.001] had significantly higher HOMA-IR which remained statistically significant even after adjusting for age and gender. There was a linear increase in the mean values of HOMA IR with increase in number of components of MS [p for trend < 0.001]

CONCLUSION

Among Asian Indians who are known to have high risk of premature coronary artery disease and diabetes, a significant association exists between insulin resistance with cardiovascular risk factors even among NGT subjects.

Authors+Show Affiliations

Department of Epidemiology, Madras Diabetes Research Foundation, Chennai.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

21887902

Citation

Sandeep, S, et al. "Insulin Resistance Is Associated With Increased Cardiovascular Risk in Asian Indians With Normal Glucose Tolerance--the Chennai Urban Rural Epidemiology Study (CURES-66)." The Journal of the Association of Physicians of India, vol. 59, 2011, pp. 480-4.
Sandeep S, Gokulakrishnan K, Deepa M, et al. Insulin resistance is associated with increased cardiovascular risk in Asian Indians with normal glucose tolerance--the Chennai Urban Rural Epidemiology Study (CURES-66). J Assoc Physicians India. 2011;59:480-4.
Sandeep, S., Gokulakrishnan, K., Deepa, M., & Mohan, V. (2011). Insulin resistance is associated with increased cardiovascular risk in Asian Indians with normal glucose tolerance--the Chennai Urban Rural Epidemiology Study (CURES-66). The Journal of the Association of Physicians of India, 59, 480-4.
Sandeep S, et al. Insulin Resistance Is Associated With Increased Cardiovascular Risk in Asian Indians With Normal Glucose Tolerance--the Chennai Urban Rural Epidemiology Study (CURES-66). J Assoc Physicians India. 2011;59:480-4. PubMed PMID: 21887902.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Insulin resistance is associated with increased cardiovascular risk in Asian Indians with normal glucose tolerance--the Chennai Urban Rural Epidemiology Study (CURES-66). AU - Sandeep,S, AU - Gokulakrishnan,K, AU - Deepa,M, AU - Mohan,V, PY - 2011/9/6/entrez PY - 2011/9/6/pubmed PY - 2011/10/1/medline SP - 480 EP - 4 JF - The Journal of the Association of Physicians of India JO - J Assoc Physicians India VL - 59 N2 - OBJECTIVE: The aim of the study was to assess the association of Insulin Resistance [IR] assessed by Homeostasis Assessment model (HOMA-IR) with cardiovascular risk factors in subjects with Normal Glucose Tolerance [NGT] in Asian Indians. METHODS: This cross-sectional study recruited subjects from the Chennai Urban Rural Epidemiology Study [CURES] an epidemiological study in a representative population of Chennai [formerly Madras], in South India. We included 1550 subjects with normal glucose tolerance, ie, fasting plasma glucose < 100 mg/dl [5.6 mmol/L] and 2 hour post load plasma glucose < 140 mg/dl [7.8 mmol/L]. IR was calculated using the homeostasis assessment model (HOMA-IR) using the formula: fasting insulin (1IU/mL) fasting glucose (mmol/L)/22.5. Metabolic syndrome [MS] was defined based on modified Adult Treatment Panel III (ATP III) guidelines. RESULTS: HOMA-IR was found to be significantly associated with systolic blood pressure (beta = 0.100, p < 0.001), diastolic pressure (beta = 0.094, p < 0.001), total cholesterol (beta = 0.068, p = 0.005), serum triglycerides (beta = 0.105, p < 0.001), LDL cholesterol (beta = 0.118, p < 0.005), and HDL cholesterol (beta = -0.060, p < 0.001) even after adjusting age, gender and BMI. Subjects with family history of type 2 diabetes had significantly higher HOMA-IR [p = 0.011] compared to those without family history. In relation to physical activity, subjects with heavy grade activity had significantly lower HOMA-IR values compared to the light grade activity [p < 0.001] Subjects with generalized obesity [p < 0.001] and abdominal obesity [p < 0.001] had significantly higher HOMA-IR which remained statistically significant even after adjusting for age and gender. There was a linear increase in the mean values of HOMA IR with increase in number of components of MS [p for trend < 0.001] CONCLUSION: Among Asian Indians who are known to have high risk of premature coronary artery disease and diabetes, a significant association exists between insulin resistance with cardiovascular risk factors even among NGT subjects. SN - 0004-5772 UR - https://www.unboundmedicine.com/medline/citation/21887902/Insulin_resistance_is_associated_with_increased_cardiovascular_risk_in_Asian_Indians_with_normal_glucose_tolerance__the_Chennai_Urban_Rural_Epidemiology_Study__CURES_66__ L2 - https://medlineplus.gov/metabolicsyndrome.html DB - PRIME DP - Unbound Medicine ER -