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Insulin Resistance With Normal BMI Linked to Mortality Risk

Study evaluated adults without diabetes; found association between HOMA-IR, all-cause mortality

THURSDAY, June 10 (HealthDay News) -- In adults of normal weight without diabetes, insulin resistance -- as measured with the homeostasis model assessment for insulin resistance (HOMA-IR) -- is associated with all-cause mortality, according to research published in the June issue of Diabetes Care.

Karlee J. Ausk, M.D., of the Veterans Affairs Puget Sound Health Care System in Seattle, and colleagues analyzed data from 5,511 adults without diabetes participating in the National Health and Nutrition Examination Survey from 1988 to 1994. Subjects were followed for up to 12 years.

The researchers found that HOMA-IR was associated with all-cause mortality, with an adjusted hazard ratio of 1.16 when comparing successive quartiles of HOMA-IR in a linear model, and 1.64 when comparing the top quartile to the bottom. However, HOMA-IR was only significantly associated with all-cause mortality in people with a body mass index (BMI) below 25.2 kg/m², not at or above. Those in the second through fourth HOMA-IR quartiles seemed to have higher cardiovascular mortality than those in the lowest quartile.

"HOMA-IR is associated with mortality in the U.S. population particularly among individuals with normal BMI. HOMA-IR is a readily available measure that can be used in the future to predict mortality in clinical or epidemiological settings. The distinction between the implications of elevated HOMA-IR in subjects with normal BMI versus elevated BMI deserves further investigation and may shed light on the pathophysiology of insulin resistance and its consequences," the authors write.

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