Highlights
- •Insulin resistance is a risk factor for coronary artery disease.
- •Both prediabetes (PreDM) and hypertriglyceridemia (↑TG) are associated with insulin resistance.
- •Combination of PreDM + ↑TG is associated with increased coronary artery disease risk.
- •Coronary artery calcium (CAC) is detectable in apparently healthy individuals.
- •Detectable coronary artery calcium is increased in those with combined PreDM + ↑TG.
Background
Insulin resistance in apparently healthy persons is associated with a cluster of metabolic
abnormalities that promote coronary atherosclerosis. Identifying these individuals
before manifest disease would provide useful clinical information.
Objective
We hypothesized that combining 2 simple markers of insulin resistance, prediabetes
(PreDM) and triglyceride (TG) concentration ≥150 mg/dL, would identify apparently
healthy persons with adverse cardiometabolic risk profiles and increased coronary
artery calcium (CAC) compared with those with neither or only 1 abnormality.
Methods
A cross-sectional analysis was performed using data from 25,886 apparently healthy
individuals (18,453 men and 7433 women) evaluated at the Cooper Clinic from 1998 to
2015. Participants were divided into those with a normal fasting glucose concentrations
(<100 mg/dL = normal fasting glucose) or PreDM (fasting plasma glucose ≥100 and <126 mg/dL)
and further subdivided into those with a plasma TG concentration <150 or ≥150 mg/dL.
These 4 groups were compared on the basis of multiple coronary artery disease risk
factors and the presence of CAC determined during their evaluation.
Results
Participants with PreDM and a TG concentration ≥150 mg/dL had a significantly more
adverse coronary artery disease risk profile than individuals with either abnormality
or only 1 abnormality (PreDM or TG concentration ≥150 mg/dL). Furthermore, the odds
of detectable CAC were higher in participants with PreDM and a TG ≥ 150 mg/dL than
in participants with neither or only 1 abnormality.
Conclusion
The presence of 2 markers of insulin resistance, PreDM and TG concentration ≥150 mg/dL,
is associated with increased cardiometabolic risk and detectable CAC within a population
of apparently healthy individuals.
Keywords
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Article Info
Publication History
Published online: June 05, 2017
Accepted:
May 27,
2017
Received:
April 19,
2017
Identification
Copyright
© 2017 National Lipid Association. All rights reserved.
