HOMA insulin sensitivity index and the risk of all-cause mortality and cardiovascular disease events in the general population : the Australian diabetes, obesity and lifestyle study (AusDiab) study

Barr, E. L. M., Cameron, A. J., Balkau, B., Zimmet, P. Z., Welborn, T. A., Tonkin, A. M. and Shaw, J. E. 2010, HOMA insulin sensitivity index and the risk of all-cause mortality and cardiovascular disease events in the general population : the Australian diabetes, obesity and lifestyle study (AusDiab) study, Diabetologia: clinical and experimental diabetes and metabolism, vol. 53, no. 1, pp. 79-88.


Title HOMA insulin sensitivity index and the risk of all-cause mortality and cardiovascular disease events in the general population : the Australian diabetes, obesity and lifestyle study (AusDiab) study
Author(s) Barr, E. L. M.
Cameron, A. J.
Balkau, B.
Zimmet, P. Z.
Welborn, T. A.
Tonkin, A. M.
Shaw, J. E.
Journal name Diabetologia: clinical and experimental diabetes and metabolism
Volume number 53
Issue number 1
Start page 79
End page 88
Total pages 10
Publisher Springer
Place of publication Berlin, Germany
Publication date 2010-01
ISSN 0012-186X
1432-0428
Keyword(s) cardiovascular diseases
hyperglycaemia
insulin sensitivity and resistance
metabolic syndrome
mortality
Summary Aims/hypothesis We assessed whether the relationships between insulin sensitivity and all-cause mortality as well as fatal or non-fatal cardiovascular disease (CVD) events are independent of elevated blood glucose, high blood pressure, dyslipidaemia and body composition in individuals without diagnosed diabetes.
Methods
Between 1999 and 2000, baseline fasting insulin, glucose and lipids, 2 h plasma glucose, HbA1c, anthropometrics, blood pressure, medication use, smoking and history of CVD were collected from 8,533 adults aged >35 years from the population-based Australian Diabetes, Obesity and Lifestyle study. Insulin sensitivity was estimated by HOMA of insulin sensitivity (HOMA-%S). Deaths and fatal or non-fatal CVD events were ascertained through linkage to the National Death Index and medical records adjudication.
Results
After a median of 5.0 years there were 277 deaths and 225 CVD events. HOMA-%S was not associated with all-cause mortality. Compared with the most insulin-sensitive quintile, the combined fatal or non-fatal CVD HR (95% CI) for quintiles of decreasing HOMA-%S were 1.1 (0.6–1.9), 1.4 (0.9–2.3), 1.6 (1.0–2.5) and 2.0 (1.3–3.1), adjusting for age and sex. Smoking, CVD history, hypertension, lipid-lowering medication, total cholesterol and waist-to-hip ratio moderately attenuated this relationship. However, the association was rendered non-significant by adding HDL. Fasting plasma glucose, but not HOMA-%S significantly improved the prediction of CVD, beyond that seen with other risk factors.
Conclusions/interpretation In this cohort, HOMA-%S showed no association with all-cause mortality and only a modest association with CVD events, largely explained by its association with HDL. Fasting plasma glucose was a better predictor of CVD than HOMA-%S.
Language eng
Field of Research 111706 Epidemiology
Socio Economic Objective 920104 Diabetes
HERDC Research category C1.1 Refereed article in a scholarly journal
Copyright notice ©2009, Springer-Verlag
Persistent URL http://hdl.handle.net/10536/DRO/DU:30021313

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