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Increased risk for development of coronary artery calcification in insulin-resistant subjects who developed diabetes: 4-year longitudinal study

Authors
Rhee, Eun-JungKim, Ji HyunPark, Hye-JeongPark, Se EunOh, Hyung-GeunPark, Cheol-YoungLee, Won-YoungOh, Ki-WonPark, Sung-Woo
Issue Date
Feb-2016
Publisher
Elsevier BV
Keywords
Coronary artery calcification; Insulin resistance; Glycemic progression
Citation
Atherosclerosis, v.245, pp 132 - 138
Pages
7
Journal Title
Atherosclerosis
Volume
245
Start Page
132
End Page
138
URI
https://scholarworks.bwise.kr/sch/handle/2021.sw.sch/9396
DOI
10.1016/j.atherosclerosis.2015.12.010
ISSN
0021-9150
1879-1484
Abstract
Objective: Coronary artery calcification (CAC) is considered a surrogate marker for atherosclerotic burden. The aim of this study was to analyze the risk of incident CAC associated with diabetes development in non-diabetic subjects with zero CAC score (CACS) at baseline. Methods: 2076 non-diabetic participants (mean age 40 years) in a health screening program in whom CACS were repeatedly measured by multi-detector computed tomography in four years of intervals and with zero CACS at baseline, were retrospectively analyzed. Glycemic status was assessed in both years, with subjects divided into three groups: subjects with 'no progression', 'normal to impaired fasting glucose (IFG)' and 'progression to diabetes'. Insulin resistance was assessed by homeostasis model assessment-insulin resistance (HOMA-IR) index. Results: Over 4 years, 204 subjects (9.8%) developed CAC. Subjects who developed diabetes showed the highest proportion of subjects with incident CAC among the three groups (21.0% vs. 9.3 and 10.4% in non-progressors and subjects from normal to IFG). The subjects with HOMA-IR level in higher half at baseline showed significantly increased risk for incident CAC in subjects who progressed from normal to IFG and in subjects who developed diabetes (1.740; 95% CI 1.014-2.985, 2.449; 95% CI 1.159-5.174) even after adjustment for confounding variables, whereas subjects with HOMA-IR level in lower half at baseline showed no significantly increased risk for incident CAC even in subjects who developed diabetes. Conclusions: In this non-diabetic population, we found that increased risk for incident CAC in relation to diabetes development over 4 years was pronounced only in subjects with insulin resistance at baseline. (C) 2015 Elsevier Ireland Ltd. All rights reserved.
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