Low Insulin Sensitivity Measured by Both Quantitative Insulin Sensitivity Check Index and Homeostasis Model Assessment Method as a Risk Factor of Increased Intima-Media Thickness of the Carotid Artery

• Published in: The journal of clinical endocrinology and metabolism Vol. 87; no. 11; pp. 5092 - 5097
• Main Authors: Rajala, Ulla, Laakso, Mauri, Päivänsalo, Markku, Pelkonen, Outi, Suramo, Ilkka, Keinänen-Kiukaanniemi, Sirkka
• Format: Journal Article
• Language: English
• Published: United States Endocrine Society 01.11.2002
• Subjects: Blood Glucose - metabolism; Blood Pressure; Carotid Arteries - diagnostic imaging; Carotid Artery Diseases - diagnostic imaging; Carotid Artery Diseases - epidemiology; Cholesterol, HDL - blood; Fasting; Female; Glucose Intolerance - epidemiology; Homeostasis; Humans; Hypertension - epidemiology; Insulin - blood; Insulin - pharmacology; Insulin Resistance; Male; Middle Aged; Odds Ratio; Regression Analysis; Risk Factors; Sex Characteristics; Smoking - epidemiology; Triglycerides - blood; Ultrasonography
• ISSN: 0021-972X; 1945-7197
• DOI: 10.1210/jc.2002-020703

The present study evaluated the association of ultrasonographic manifestations of carotid atherosclerosis with glucose status, various components of the insulin resistance syndrome, and insulin sensitivity measured by a novel quantitative insulin sensitivity check index (QUICKI = 1/[log(I0) + log (G0)]). Carotid ultrasonographic measurements were performed on 54 diabetic subjects, 97 subjects with impaired glucose tolerance and 57 normoglycemic subjects. QUICKI and insulin resistance measured by a HOMA (homeostasis model assessment) method had a high negative correlation (r = −0.995, P < 0.001). QUICKI was lower in diabetic subjects (0.319 ± 0.022) than in subjects with impaired glucose tolerance (0.334 ± 0.027) or normoglycemia (0.335 ± 0.022, P = 0.002). There was an increasing trend in the mean and maximal intima-media thickness (IMT) of the common carotid artery (CCA) with worsening of glucose status. The maximal IMT of the CCA correlated inversely with QUICKI (r = −0.158, P = 0.027). The prevalence of severe CCA atherosclerosis (maximal IMT of the CCA ≥ 1.2 mm) was 41% in men and 16% in women (P < 0.001). It was also associated with a long (≥26 yr) smoking history. The prevalence of severe CCA atherosclerosis was 11% in the highest QUICKI tertile, 36% in the middle tertile, and 33% in the lowest tertile (P = 0.002). Systolic blood pressure was higher and high-density lipoprotein cholesterol lower in subjects with severe CCA atherosclerosis, compared with those without it. In multiple regression analysis, the adjusted odds ratio for severe CCA atherosclerosis was 5.7 (95% confidence interval, 2.2–15.1) in subjects in the two lowest tertiles of QUICKI, compared with those in the highest tertile.