ArticleCardiovascular diabetology2011
Insulin resistance increases the occurrence of new cardiovascular events in patients with manifest arterial disease without known diabetes. the SMART study.
Article in Cardiovascular diabetology, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
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Who cites it
20 citing papers in PubMed, 36 citations in OpenAlex.
- Association Between Insulin Resistance Marker Estimated Glucose Disposal Rate and Cardiovascular Risk in Obesity: Insights From the National Health and Nutrition Examination Survey 1999 to 2018.Cardiology research · 2026Article
- Insulin-resistance indices and cardiovascular mortality in cardiovascular-kidney-metabolic syndrome stage 2: a comparative analysis of eGDR, TyG and METS-IR.Diabetology & metabolic syndrome · 2026Article
- The Triglyceride-Glucose Index is associated with hospital and Intensive Care Unit Mortality in critically ill patients with Acute Coronary Syndrome.Journal of research in medical sciences : the official journal of Isfahan University of Medical Sciences · 2026Article
- Associations of Estimated Glucose Disposal Rate With Stroke Risk and Poststroke Adverse Outcomes: A Prospective Cohort Study.CNS neuroscience & therapeutics · 2025Article
- Development of type 2 diabetes and insulin resistance in people with HIV infection: Prevalence, incidence and associated factors.PloS one · 2021Article
- Target Elimination-Denatured and Unstable Proteins, Environmental Toxins, Metabolic Wastes, Immunosuppressive Factors and Chronic Inflammatory Factors of Medical System for Chronic Diseases Prevention and Health Promotion: A Narrative Review.Iranian journal of public health · 2019Review
- Lifestyle modification interventions differing in intensity and dietary stringency improve insulin resistance through changes in lipoprotein profiles.Obesity science & practice · 2016Article
- Association between alpha-fetoprotein and metabolic syndrome in a Chinese asymptomatic population: a cross-sectional study.Lipids in health and disease · 2016Article
- Chronic stress, inflammation, and glucose regulation in U.S. Hispanics from the HCHS/SOL Sociocultural Ancillary Study.Psychophysiology · 2015Article
- Implications of ghrelin and hexarelin in diabetes and diabetes-associated heart diseases.Endocrine · 2015Review
- Two novel mutations identified in familial cases with Donohue syndrome.Molecular genetics & genomic medicine · 2014Article
- Influence of fibrinogen and C-RP on progression of peripheral arterial disease in type 2 diabetes: a preliminary report.Cardiovascular diabetology · 2013Article
- Blood glucose may be an alternative to cholesterol in CVD risk prediction charts.Cardiovascular diabetology · 2013Article
- Macrovascular complication phenotypes in type 2 diabetic patients.Cardiovascular diabetology · 2013Article
- Article
- A polymorphism of HMGA1 is associated with increased risk of metabolic syndrome and related components.Scientific reports · 2013Article
- Balanced pan-PPAR activator bezafibrate in combination with statin: comprehensive lipids control and diabetes prevention?Cardiovascular diabetology · 2012Review
- Latent associations of low serum amylase with decreased plasma insulin levels and insulin resistance in asymptomatic middle-aged adults.Cardiovascular diabetology · 2012Article
- Shadow of diabetes over cardiovascular disease: comparative quantification of population-attributable all-cause and cardiovascular mortality.Cardiovascular diabetology · 2012Article
- Blood pressure and lipid management fall far short in persons with type 2 diabetes: results from the DIAB-CORE Consortium including six German population-based studies.Cardiovascular diabetology · 2012Article
Corrections and comments
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundInsulin resistance is accompanied by a cluster of metabolic changes, often referred to as metabolic syndrome. Metabolic syndrome is associated with an increased cardiovascular risk in patients with manifest arterial disease. We investigated whether insulin resistance is associated with an increased risk for cardiovascular events in patients with manifest arterial disease without known diabetes and whether this can be explained by the components of the metabolic syndrome or by inflammation.
methodsProspective cohort study in 2611 patients with manifest arterial disease without known diabetes. Homeostasis model of insulin resistance (HOMA-IR) was used to quantify insulin resistance. The relation of HOMA-IR with cardiovascular events (vascular death, myocardial infarction or stroke) and all cause mortality was assessed with Cox regression analysis. In additional models adjustments were performed for the single components constituting the metabolic syndrome and for inflammation.
resultsHOMA-IR increases with the number of metabolic syndrome components (mean HOMA-IR ± SD in groups with 0, 1, 2, 3, 4 and 5 metabolic syndrome components: 1.4 ± 0.7; 1.8 ± 1.2; 2.4 ± 1.5; 3.1 ± 1.8; 4.0 ± 2.6; and 5.6 ± 3.6 respectively). High HOMA-IR was independently associated with an increased risk of cardiovascular events (tertile 2 vs. 1 HR 1.92; 95%CI 1.20-3.08) (tertile 3 vs.1 HR 1.78; 95%CI 1.10-2.89) and with all cause mortality (tertile 2 vs. 1 HR 1.80; 95%CI 1.04-3.10) (tertile 3 vs.1 HR 1.56; 95%CI 0.88-2.75). These relations were not influenced by the individual components of metabolic syndrome or by inflammation.
conclusionsIn patients with manifest arterial disease without known diabetes, insulin resistance increases with the number of metabolic syndrome components, and elevated insulin resistance increases the risk of new cardiovascular events.
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