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Open AccessArticle

The Association between Insulin Resistance and Cardiovascular Disease Risk: A Community-Based Cross-Sectional Study among Taiwanese People Aged over 50 Years

1
Department of Family Medicine, Chang-Gung Memorial Hospital, Linkou Branch, Taoyuan City 33305, Taiwan
2
. Department of Family Medicine, Chang Gung Memorial Hospital, Taoyuan Branch, Taoyuan City 33378, Taiwan
3
. College of Medicine, Chang Gung University, Taoyuan City 33302, Taiwan
4
. Department of Health Management, Xiamen Chang-Gung Hospital, Xiamen 361000, China
5
. Department of Family Medicine, New Taipei Municipal TuCheng Hospital, New Taipei City 23652, Taiwan
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2020, 17(19), 7195; https://doi.org/10.3390/ijerph17197195
Received: 22 August 2020 / Revised: 24 September 2020 / Accepted: 29 September 2020 / Published: 1 October 2020
Background and Aims: Previous studies have implied that insulin resistance (IR) could represent a major underlying abnormality leading to cardiovascular disease (CVD). The aim of this study was to evaluate the relationships between IR (estimated by the homeostasis model assessment of IR (HOMA-IR) index) and CVD risk among middle-aged and elderly Taiwanese individuals. Methods: In this cross-sectional, community-based study, a total of 320 participants were interviewed to collect demographical parameters and blood samples. The recruited participants were divided into tertiles according to their levels of HOMA-IR. The Framingham risk score (FRS) was calculated according to the 2008 general CVD risk model from the Framingham Heart Study. Results: The HOMA-IR index was significantly correlated with the FRS, with a Pearson’s coefficient of 0.22. In the multiple logistic regression model, a higher HOMA-IR level was significantly associated with a high FRS (FRS ≥ 20%) (highest tertile vs. lowest tertile of HOMA-IR, crude OR = 3.69; 95% CI = 1.79–7.62), even after adjusting for smoking, fasting plasma glucose (FPG), and systolic blood pressure (SBP) (highest tertile vs. lowest tertile of HOMA-IR, adjusted OR = 11.51; 95% CI = 2.55–51.94). The area under the receiver operating characteristic curve for the HOMA-IR index as the predictor of high FRS was 0.627, and the optimal HOMA-IR cutoff value was 1.215 (sensitivity = 83.6%, specificity = 42.9%). Conclusions: We considered that HOMA-IR is an independent factor but that it cannot be used solely for evaluating the CVD risk due to the low AUC value. Further prospective cohort studies are warranted to better assess the relationship between CVD risk and insulin resistance. View Full-Text
Keywords: insulin resistance; HOMA-IR; prediction; CVD; Framingham risk score insulin resistance; HOMA-IR; prediction; CVD; Framingham risk score
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Lu, M.-C.; Fang, W.-C.; Li, W.-C.; Yeh, W.-C.; Shieh, Y.-H.; Chen, J.-Y. The Association between Insulin Resistance and Cardiovascular Disease Risk: A Community-Based Cross-Sectional Study among Taiwanese People Aged over 50 Years. Int. J. Environ. Res. Public Health 2020, 17, 7195.

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