Insulin resistance and metabolic syndrome as independent predictors of incident cardiovascular disease
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The goal of this prospective Danish population-based study from the MONICA-1 register including 2493 men and women aged 41 to 72 years was to clarify whether insulin resistance (HOMA-IR) would predict cardiovascular disease (CVD) independently of the metabolic syndrome. In this patient population, the prevalence of the metabolic syndrome was 21% according to International Diabetes Foundation (IDF) criteria and 16% according to National Cholesterol Education Program (NCPE) criteria; IDF-HOMA-IR was defined accordingly as belonging to the highest 21% of the HOMA-IR distribution, and NCPE-HOMA-IR as belonging to the highest 16% of the HOMA-IR distribution. During the median 9.4-year follow-up, 233 CV end-points occurred. After adjusting for age, gender, smoking, and low-density lipoprotein cholesterol, proportional hazard models including both IDF-HOMA-IR and IDF-metabolic syndrome in the same model revealed that the relative risk of an end point was 1.67 for IDF-HOMA-IR and 1.16 for IDF-metabolic syndrome. The corresponding figures for NCEP-HOMA-IR and NCEP-metabolic syndrome were 1.49 and 1.56, respectively. In conclusion, both HOMA-IR and NCEP-metabolic syndrome were independent predictors of incident CVD in this population-based, non-diabetic, prospective study.
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