Lower Definition of Insulin Resistance Tied to Heart Failure
HOMA-IR values of 1.0 to 2.0, but not over 2.5, tied to heart failure
TUESDAY, Dec. 17, 2013 (HealthDay News) -- Using a definition of insulin resistance with lower levels of homeostatic model assessment of insulin resistance (HOMA-IR) than previously considered, insulin resistance is associated with an increased risk for heart failure, according to a study published in the December issue of the Journal of the American College of Cardiology: Heart Failure.
Orly Vardeny, Pharm.D., from University of Wisconsin in Madison, and colleagues prospectively analyzed 12,606 participants in the Atherosclerosis Risk in Communities study without diabetes mellitus, prevalent heart failure, or history of myocardial infarction at baseline (1987 to 1989). A HOMA-IR equation was used to assess the relationship between insulin resistance and incident heart failure.
The researchers found that participants with insulin resistance (HOMA-IR ≥2.5 [4,810 patients]) were older, more likely female, African-American, hypertensive, and had a higher body mass index compared to those without insulin resistance. During a median of 20.6 years of follow-up there were 1,455 incident heart failure cases. After adjusting for other variables, insulin resistance was not significantly associated with an increased risk for incident heart failure (hazard ratio, 1.08; 95 percent confidence interval, 0.95 to 1.23). However, this relationship was nonlinear when analyzed continuously, indicating increased risk, with a significant association with incident heart failure and HOMA-IR of 1.0 to 2.0. HOMA-IR values over 2.5 were not associated with additional increased risk in adjusted models.
"In a community cohort, insulin resistance, defined by lower levels of HOMA-IR than previously considered, was associated with an increased risk for heart failure," the authors conclude.