Demographic and Cardiovascular Risk Factors Modify Association of Fasting Insulin With Incident Coronary Heart Disease and Ischemic Stroke (from the Atherosclerosis Risk In Communities Study)

Laura J. Rasmussen-Torvik, Hiroshi Yatsuya, Elizabeth Selvin, Alvaro Alonso, Aaron R. Folsom

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Previous studies have reported an association between circulating insulin and incident cardiovascular disease, but limited knowledge is available on the association across subgroups. We examined the associations of fasting insulin with incident coronary heart disease (CHD) and ischemic stroke in multiple subgroups of a biracial, middle-age cohort. A total of 12,323 subjects were included in the analysis. The incidence of CHD (n = 960) and ischemic stroke (n = 445) through 2005 was determined through annual interviews, repeat examinations, and community surveillance. Serum insulin was measured at baseline. Cox regression analysis was used to estimate the hazard ratios by quintile of fasting insulin at baseline and to determine the significance of effect modification. In the minimally adjusted models (age, gender, race, and field center), the baseline fasting insulin quintile was positively associated with both incident CHD (hazard ratio per quintile insulin = 1.12, p-trend <0.0001) and ischemic stroke (hazard ratio per quintile insulin = 1.11, p = 0.0018). The adjustment for high-density lipoprotein completely attenuated the association of insulin with CHD but not with stroke. The associations of insulin with CHD were stronger in nonsmokers (p-interaction = 0.018) and in those without hypertension (p-interaction = 0.0087). The associations of insulin with stroke were stronger in women (p-interaction = 0.037), whites (compared to blacks; p-interaction = 0.036), and those without hypertension (p-interaction = 0.0027).

Original languageEnglish
Pages (from-to)1420-1425
Number of pages6
JournalAmerican Journal of Cardiology
Volume105
Issue number10
DOIs
Publication statusPublished - 15-05-2010
Externally publishedYes

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Coronary Disease
Fasting
Atherosclerosis
Stroke
Demography
Insulin
Hypertension
HDL Lipoproteins
Cardiovascular Diseases
Regression Analysis
Interviews
Incidence
Serum

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

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title = "Demographic and Cardiovascular Risk Factors Modify Association of Fasting Insulin With Incident Coronary Heart Disease and Ischemic Stroke (from the Atherosclerosis Risk In Communities Study)",
abstract = "Previous studies have reported an association between circulating insulin and incident cardiovascular disease, but limited knowledge is available on the association across subgroups. We examined the associations of fasting insulin with incident coronary heart disease (CHD) and ischemic stroke in multiple subgroups of a biracial, middle-age cohort. A total of 12,323 subjects were included in the analysis. The incidence of CHD (n = 960) and ischemic stroke (n = 445) through 2005 was determined through annual interviews, repeat examinations, and community surveillance. Serum insulin was measured at baseline. Cox regression analysis was used to estimate the hazard ratios by quintile of fasting insulin at baseline and to determine the significance of effect modification. In the minimally adjusted models (age, gender, race, and field center), the baseline fasting insulin quintile was positively associated with both incident CHD (hazard ratio per quintile insulin = 1.12, p-trend <0.0001) and ischemic stroke (hazard ratio per quintile insulin = 1.11, p = 0.0018). The adjustment for high-density lipoprotein completely attenuated the association of insulin with CHD but not with stroke. The associations of insulin with CHD were stronger in nonsmokers (p-interaction = 0.018) and in those without hypertension (p-interaction = 0.0087). The associations of insulin with stroke were stronger in women (p-interaction = 0.037), whites (compared to blacks; p-interaction = 0.036), and those without hypertension (p-interaction = 0.0027).",
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Demographic and Cardiovascular Risk Factors Modify Association of Fasting Insulin With Incident Coronary Heart Disease and Ischemic Stroke (from the Atherosclerosis Risk In Communities Study). / Rasmussen-Torvik, Laura J.; Yatsuya, Hiroshi; Selvin, Elizabeth; Alonso, Alvaro; Folsom, Aaron R.

In: American Journal of Cardiology, Vol. 105, No. 10, 15.05.2010, p. 1420-1425.

Research output: Contribution to journalArticle

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