Independent Associations of Fasting Insulin, Glucose, and Glycated Haemoglobin with Stroke and Coronary Heart Disease in Older Women
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{"title"=>"Independent associations of fasting insulin, glucose, and glycated haemoglobin with stroke and coronary heart disease in older women", "type"=>"journal", "authors"=>[{"first_name"=>"Debbie A.", "last_name"=>"Lawlor", "scopus_author_id"=>"7102452820"}, {"first_name"=>"Abigail", "last_name"=>"Fraser", "scopus_author_id"=>"55770838500"}, {"first_name"=>"Shah", "last_name"=>"Ebrahim", "scopus_author_id"=>"7102093023"}, {"first_name"=>"George Davey", "last_name"=>"Smith", "scopus_author_id"=>"35354080500"}], "year"=>2007, "source"=>"PLoS Medicine", "identifiers"=>{"pui"=>"47358175", "sgr"=>"34548459499", "issn"=>"15491277", "pmid"=>"17760500", "scopus"=>"2-s2.0-34548459499", "doi"=>"10.1371/journal.pmed.0040263", "isbn"=>"1549-1676 (Electronic)\\r1549-1277 (Linking)"}, "id"=>"92de4a3d-3edd-32b9-a46b-2bfa89f22e14", "abstract"=>"BACKGROUND: Evidence suggests that variations in fasting glucose and insulin amongst those without frank type 2 diabetes mellitus are important determinants of cardiovascular disease. However, the relative importance of variations in fasting insulin, glucose, and glycated haemoglobin as risk factors for cardiovascular disease in women without diabetes is unclear. Our aim was to determine the independent associations of fasting insulin, glucose, and glycated haemoglobin with coronary heart disease and stroke in older women. METHODS AND FINDINGS: We undertook a prospective cohort study of 3,246 British women aged 60-79 y, all of whom were free of baseline coronary heart disease, stroke, and diabetes, and all of whom had fasting glucose levels below 7 mmol/l. Fasting insulin and homeostasis model assessment for insulin sensitivity (HOMA-S) were linearly associated with a combined outcome of coronary heart disease or stroke (n = 219 events), but there was no association of fasting glucose or glycated haemoglobin with these outcomes. Results were similar for coronary heart disease and stroke as separate outcomes. The age, life-course socioeconomic position, smoking, and physical activity adjusted hazard ratio for a combined outcome of incident coronary heart disease or stroke per one standard deviation of fasting insulin was 1.14 (95% CI 1.02-1.33). Additional adjustment for other components of metabolic syndrome, low-density lipoprotein cholesterol, fasting glucose, and glycated haemoglobin had little effect on this result. CONCLUSIONS: Our findings suggest that in women in the 60-79 y age range, insulin resistance, rather than insulin secretion or chronic hyperglycaemia, is a more important risk factor for coronary heart disease and stroke. Below currently used thresholds of fasting glucose for defining diabetes, neither fasting glucose nor glycated haemoglobin are associated with cardiovascular disease.", "link"=>"http://www.mendeley.com/research/independent-associations-fasting-insulin-glucose-glycated-haemoglobin-stroke-coronary-heart-disease", "reader_count"=>33, "reader_count_by_academic_status"=>{"Unspecified"=>2, "Professor > Associate Professor"=>3, "Librarian"=>2, "Researcher"=>5, "Student > Doctoral Student"=>3, "Student > Ph. D. Student"=>6, "Student > Postgraduate"=>2, "Student > Master"=>6, "Lecturer"=>1, "Lecturer > Senior Lecturer"=>1, "Professor"=>2}, "reader_count_by_user_role"=>{"Unspecified"=>2, "Professor > Associate Professor"=>3, "Librarian"=>2, "Researcher"=>5, "Student > Doctoral Student"=>3, "Student > Ph. D. Student"=>6, "Student > Postgraduate"=>2, "Student > Master"=>6, "Lecturer"=>1, "Lecturer > Senior Lecturer"=>1, "Professor"=>2}, "reader_count_by_subject_area"=>{"Unspecified"=>5, "Nursing and Health Professions"=>2, "Agricultural and Biological Sciences"=>3, "Medicine and Dentistry"=>17, "Arts and Humanities"=>1, "Neuroscience"=>1, "Sports and Recreations"=>1, "Social Sciences"=>2, "Computer Science"=>1}, "reader_count_by_subdiscipline"=>{"Medicine and Dentistry"=>{"Medicine and Dentistry"=>17}, "Neuroscience"=>{"Neuroscience"=>1}, "Social Sciences"=>{"Social Sciences"=>2}, "Sports and Recreations"=>{"Sports and Recreations"=>1}, "Agricultural and Biological Sciences"=>{"Agricultural and Biological Sciences"=>3}, "Computer Science"=>{"Computer Science"=>1}, "Nursing and Health Professions"=>{"Nursing and Health Professions"=>2}, "Unspecified"=>{"Unspecified"=>5}, "Arts and Humanities"=>{"Arts and Humanities"=>1}}, "reader_count_by_country"=>{"Netherlands"=>1, "Brazil"=>1, "Portugal"=>1}, "group_count"=>1}

Scopus | Further Information

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Figshare

  • {"files"=>["https://ndownloader.figshare.com/files/467378"], "description"=>"<div><h3>Background</h3><p>Evidence suggests that variations in fasting glucose and insulin amongst those without frank type 2 diabetes mellitus are important determinants of cardiovascular disease. However, the relative importance of variations in fasting insulin, glucose, and glycated haemoglobin as risk factors for cardiovascular disease in women without diabetes is unclear. Our aim was to determine the independent associations of fasting insulin, glucose, and glycated haemoglobin with coronary heart disease and stroke in older women.</p> <h3>Methods and Findings</h3><p>We undertook a prospective cohort study of 3,246 British women aged 60–79 y, all of whom were free of baseline coronary heart disease, stroke, and diabetes, and all of whom had fasting glucose levels below 7 mmol/l. Fasting insulin and homeostasis model assessment for insulin sensitivity (HOMA-S) were linearly associated with a combined outcome of coronary heart disease or stroke (<em>n</em> = 219 events), but there was no association of fasting glucose or glycated haemoglobin with these outcomes. Results were similar for coronary heart disease and stroke as separate outcomes. The age, life-course socioeconomic position, smoking, and physical activity adjusted hazard ratio for a combined outcome of incident coronary heart disease or stroke per one standard deviation of fasting insulin was 1.14 (95% CI 1.02–1.33). Additional adjustment for other components of metabolic syndrome, low-density lipoprotein cholesterol, fasting glucose, and glycated haemoglobin had little effect on this result.</p> <h3>Conclusions</h3><p>Our findings suggest that in women in the 60–79 y age range, insulin resistance, rather than insulin secretion or chronic hyperglycaemia, is a more important risk factor for coronary heart disease and stroke. Below currently used thresholds of fasting glucose for defining diabetes, neither fasting glucose nor glycated haemoglobin are associated with cardiovascular disease.</p> </div>", "links"=>[], "tags"=>["associations", "fasting", "glycated", "haemoglobin", "coronary", "older", "women"], "article_id"=>152144, "categories"=>["Chemistry", "Mathematics", "Medicine", "Biotechnology"], "users"=>["Debbie A Lawlor", "Abigail Fraser", "Shah Ebrahim", "George Davey Smith"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.0040263", "stats"=>{"downloads"=>3, "page_views"=>5, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/Independent_Associations_of_Fasting_Insulin_Glucose_and_Glycated_Haemoglobin_with_Stroke_and_Coronary_Heart_Disease_in_Older_Women/152144", "title"=>"Independent Associations of Fasting Insulin, Glucose, and Glycated Haemoglobin with Stroke and Coronary Heart Disease in Older Women", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2007-08-28 00:35:44"}

PMC Usage Stats | Further Information

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Relative Metric

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