ArticleCardiovascular diabetology2023
Early insulin resistance in normoglycemic low-risk individuals is associated with subclinical atherosclerosis.
Article in Cardiovascular diabetology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.
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Who cites it
21 citing papers in PubMed, 20 citations in OpenAlex.
- Sex-specific associations of the triglyceride-glucose index with systemic inflammation and arterial stiffness in adults with normal glucose and triglyceride levels.Atherosclerosis plus · 2026Article
- Review
- Elevated Endogenous Insulin and Insulin Resistance Are Associated With Progressive Diastolic Dysfunction and Worse Cardiovascular Outcomes.Circulation. Heart failure · 2026Article
- Article
- Lipoprotein(a) and atherosclerosis risk across estimated glucose disposal rate strata: evaluating synergistic predictive utility.Lipids in health and disease · 2026Article
- Head-to-head comparison of fasting-insulin-based versus non-insulin-based insulin resistance surrogates for predicting all-cause and cardiovascular mortality in hypertensive adults across the glycemic continuum: a prospective cohort study.Cardiovascular diabetology · 2026Article
- Exploring Ceramide C16:0 as a Novel Biomarker and Therapeutic Target for Atherosclerosis.Journal of the American Heart Association · 2026Review
- The insulin resistance-systemic vascular resistance-isolated diastolic hypertension axis: a metabolic framework for an overlooked hypertension phenotype.Frontiers in cardiovascular medicine · 2026Review
- Is Insulin Resistance the Driver or the Outcome of Diabetes Mellitus? A Critical Review.Journal of nutrition and metabolism · 2026Review
- Association of Non-Insulin-Based Insulin Resistance Indices With Risk of Incident Valvular Heart Disease: Results From the UK Biobank Cohort Study.Journal of the American Heart Association · 2025Article
- The Synergistic Risk of Insulin Resistance and Renal Dysfunction in Acute Coronary Syndrome Patients After Percutaneous Coronary Intervention.Journal of cardiovascular development and disease · 2025Article
- An activator of phosphatidylinositol 3-kinase alpha restores cardioprotection from ischaemia/reperfusion injury in mice with coronary atherosclerosis or insulin resistance.Cardiovascular research · 2025Article
- Chronotype, Lifestyles, and Anthropometric and Biochemical Indices for Cardiovascular Risk Assessment Among Obese Individuals.Nutrients · 2025Article
- Atherosclerosis and Insulin Resistance: Is There a Link Between Them?Biomedicines · 2025Review
- Multiorgan Imaging for Interorgan Crosstalk in Cardiometabolic Diseases.Circulation research · 2025Review
- The Impact of Triglyceride-Glucose Index Trajectories on Incidence and Recurrent Cardiovascular Events: Evidence from a Retrospective Cohort Study.Vascular health and risk management · 2025Article
- Unveiling the dual threat: combined elevated triglyceride-glucose index and intracranial arterial stenosis burden for enhanced stroke risk stratification.Frontiers in neurology · 2025Article
- The Relationship of Insulin Resistance and Systemic Inflammation with Cardiovascular Outcomes in Non-Diabetic Patients Undergoing Coronary Artery Bypass Grafting.Journal of inflammation research · 2025Article
- Association between triglyceride-glucose index and in-hospital all-cause mortality under different glucose metabolism status among patients with coronary artery disease.BMC public health · 2024Article
- Article
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Authors and funding
13 authors at 6 institutions in 3 countries.
Funding
Abstract
backgroundElevated glycated hemoglobin (HbA1c) is associated with a higher burden of subclinical atherosclerosis (SA). However, the association with SA of earlier insulin resistance markers is poorly understood. The study assessed the association between the homeostatic model assessment of insulin resistance index (HOMA-IR) and SA in addition to the effect of cardiovascular risk factors (CVRFs) in individuals with normal HbA1c.
methodsA cohort of 3,741 middle-aged individuals from the Progression of Early Subclinical Atherosclerosis (PESA) study with basal HbA1c < 6.0% (< 42 mmol/mol) and no known CV disease underwent extensive imaging (multiterritorial vascular ultrasound and coronary artery calcium score, CACS) to assess the presence, burden, and extent of SA.
resultsIndividuals with higher HOMA-IR values had higher rates of CVRFs. HOMA-IR showed a direct association with the multiterritorial extent of SA and CACS (p < 0.001) and with global plaque volume measured by 3-dimensional vascular ultrasound (p < 0.001). After adjusting for key CVRFs and HbA1c, HOMA-IR values ≥ 3 were associated with both the multiterritorial extent of SA (odds ratio 1.41; 95%CI: 1.01 to 1.95, p = 0.041) and CACS > 0 (odds ratio 1.74; 95%CI: 1.20 to 2.54, p = 0.004), as compared with the HOMA-IR < 2 (the reference HOMA-IR category). In a stratified analysis, this association remained significant in individuals with a low-to-moderate SCORE2 risk estimate (75.6% of the cohort) but not in high-risk individuals.
conclusionsThe use of HOMA-IR identified low-risk individuals with a higher burden of SA, after adjusting for the effects of key traditional CVRFs and HbA1c. HOMA-IR is a simple measure that could facilitate earlier implementation of primary CV prevention strategies in clinical practice.
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