HOMA-Estimated Insulin Resistance Is an Independent Predictor of Cardiovascular Disease in Type 2 Diabetic Subjects
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Abstract
This study aims to investigate whether homeostasis model assessment-estimated insulin resistance (HOMA-IR) serves as an independent predictor of cardiovascular disease (CVD) in individuals with type 2 diabetes.
Methods: We conducted a longitudinal study involving 1,326 patients diagnosed with type 2 diabetes, . At baseline and after an average follow-up period of 4.5 years, we assessed conventional CVD risk factors (such as sex, age, smoking, plasma lipids, blood pressure, and metabolic control) and insulin resistance estimated by HOMA-IR. CVD was evaluated through medical history, physical examination, electrocardiography, and echo-Doppler of carotid and lower limb arteries. Cardiovascular deaths were identified by reviewing death certificates and medical records.
Results: Among the participants, 441 were identified with prevalent CVD at baseline, while 126 developed incident CVD during the follow-up period. Multiple logistic regression analyses revealed that, in addition to established CVD risk factors, HOMA-IR independently predicted both prevalent and incident CVD. A one-unit increase in (log)HOMA-IR was associated with an odds ratio for prevalent CVD at baseline of 1.31 (95% CI 1.10–1.56, P = 0.002) and for incident CVD during follow-up of 1.56 (95% CI 1.14–2.12, P < 0.001).
Conclusions: Our findings indicate that HOMA-IR serves as an independent predictor of CVD in individuals with type 2 diabetes. Addressing insulin resistance may not only improve glucose control but also potentially mitigate the risk of CVD in this patient population.
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