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(Arteriosclerosis, Thrombosis, and Vascular Biology. 2003;23:295.)
© 2003 American Heart Association, Inc.

Atherosclerosis and Lipoproteins

Association Between Insulin Resistance and Carotid Arteriosclerosis in Subjects With Normal Fasting Glucose and Normal Glucose Tolerance

Nobukazu Ishizaka; Yuko Ishizaka; Eiko Takahashi; Tadao Unuma; Ei-ichi Tooda; Ryozo Nagai; Masako Togo; Kazuhisa Tsukamoto; Hideki Hashimoto; Minoru Yamakado

From the Departments of Cardiovascular Medicine (N.I., R.N.) and Metabolic Diseases (M.T., K.T.), University of Tokyo Graduate School of Medicine, the Center for Multiphasic Health Testing and Services, Mitsui Memorial Hospital (Y.I., E. Takahashi, T.U., E. Tooda, M.Y.), and Department of Hygiene and Public Health (H.H.), Teikyo University School of Medicine, Tokyo, Japan.

Correspondence to Nobukazu Ishizaka, MD, PhD, Department of Cardiovascular Medicine, University of Tokyo, Graduate School of Medicine, Hongo 7-3-1, Bunkyo-ku, Tokyo 113-8655, Japan. E-mail nobuishizka-tky{at}umin.ac.jp

Objective— We examined the possible association between insulin resistance and carotid arteriosclerosis in subjects who had both normal fasting glucose and normal glucose tolerance after intake of a glucose load.

Methods and Results— Our subjects were individuals who underwent general health screening at our institute, which included carotid ultrasound and oral glucose tolerance testing. Of the 1238 subjects enrolled in our study, 738 (60%) were classified as normal, defined as a normal fasting glucose level and normal glucose tolerance, and 334 (27%) and 166 (13%) were classified as borderline and diabetic, respectively, according to the criteria of the Japan Diabetes Society. The homeostasis model assessment of insulin resistance (HOMA-IR) was used as the index to measure insulin resistance. In normal-type subjects, univariate analysis showed that insulin resistance, but not insulin secretion, was associated with the presence of carotid plaque. Multivariate analysis showed that HOMA-IR was positively associated with carotid plaque in normal-type subjects, with an odds ratio of 1.19 (95% confidence interval, 1.00 to 1.41; P<0.05).

Conclusions— These data suggest the possibility that the presence of higher insulin resistance could be a risk factor for carotid arteriosclerosis in subjects with normal fasting glucose and normal glucose tolerance.

Key Words: carotid ultrasound • atherosclerosis • diabetes • insulin resistance • risk factor

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