Journal
DIABETES
Volume 51, Issue 10, Pages 3069-3076Publisher
AMER DIABETES ASSOC
DOI: 10.2337/diabetes.51.10.3069
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Funding
- NHLBI NIH HHS [N01 HC55021, N01 HC55015, N01 HC55018, N01 HC55016, N01 HC55020, N01 HC55019, N01 HC55022, T32HL07024] Funding Source: Medline
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The extent to which groupings of insulin resistance-related cardiovascular risk factors synergize to produce atherosclerosis beyond what is expected from their additive effects is uncertain. The objective of this study was to measure interactions among groupings of the features of the insulin resistance syndrome (IRS) on carotid intimal-medial thickness (IMT). This crosssectional study used baseline data from the Atherosclerosis Risk in Communities Study on 11,790 adults aged 45-64 years without diagnosed diabetes, treated dyslipidemia, or coronary heart disease. The main outcome was carotid IMT, assessed using B-mode ultrasound. The excess carotid IMT attributable to each IRS grouping was determined using multiple linear regression models. There were 57 possible combinations of six IRS components (hypertension, hyperinsulinemia, obesity, hypertriglyceridemia, low HDL cholesterol, and hyperglycemia). In multivariate analysis, 29 of the 57 groupings were associated with excess carotid IMT. Individuals with all six IRS components had the greatest excess IMT compared with those without this grouping (71 mum; 95% Cl 40-102 mum). The groupings most strongly associated with excess carotid IMT included hypertension and hypertriglyceridemia. Interventions aimed at ameliorating the IRS may produce reductions in atherosclerotic risk beyond that predicted by treatment of individual IRS-related risk factors.
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