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Insulin sensitivity estimates and their longitudinal association with coronary artery disease in type 1 diabetes. Does it matter?
Mutter, Stefan; Parente, Erika B; Januszewski, Andrzej S; Simonsen, Johan R; Harjutsalo, Valma; Groop, Per-Henrik; Jenkins, Alicia J; Thorn, Lena M.
Afiliação
  • Mutter S; Folkhälsan Institute of Genetics, Folkhälsan Research Center, Biomedicum Helsinki, Haartmaninkatu 8, 00290, Helsinki, Finland.
  • Parente EB; Department of Nephrology, University of Helsinki and Helsinki University Hospital, Haartmaninkatu 4, 00290, Helsinki, Finland.
  • Januszewski AS; Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Haartmaninkatu 8, 00290, Helsinki, Finland.
  • Simonsen JR; Folkhälsan Institute of Genetics, Folkhälsan Research Center, Biomedicum Helsinki, Haartmaninkatu 8, 00290, Helsinki, Finland.
  • Harjutsalo V; Department of Nephrology, University of Helsinki and Helsinki University Hospital, Haartmaninkatu 4, 00290, Helsinki, Finland.
  • Groop PH; Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Haartmaninkatu 8, 00290, Helsinki, Finland.
  • Jenkins AJ; Sydney Pharmacy School, University of Sydney, A15, Science Rd, Camperdown, NSW, 2050, Australia.
  • Thorn LM; NHMRC Clinical Trials Centre, University of Sydney, K25, Parramatta Rd, Camperdown, NSW, 2050, Australia.
Cardiovasc Diabetol ; 23(1): 152, 2024 May 03.
Article em En | MEDLINE | ID: mdl-38702680
ABSTRACT

BACKGROUND:

Insulin resistance and chronic kidney disease are both associated with increased coronary artery disease risk. Many formulae estimating glucose disposal rate in type 1 diabetes infer insulin sensitivity from clinical data. We compare associations and performance relative to traditional risk factors and kidney disease severity between three formulae estimating the glucose disposal rate and coronary artery disease in people with type 1 diabetes.

METHODS:

The baseline glucose disposal rate was estimated by three (Williams, Duca, and Januszewski) formulae in FinnDiane Study participants and related to subsequent incidence of coronary artery disease, by baseline kidney status.

RESULTS:

In 3517 adults with type 1 diabetes, during median (IQR) 19.3 (14.6, 21.4) years, 539 (15.3%) experienced a coronary artery disease event, with higher rates with worsening baseline kidney status. Correlations between the three formulae estimating the glucose disposal rate were weak, but the lowest quartile of each formula was associated with higher incidence of coronary artery disease. Importantly, only the glucose disposal rate estimation by Williams showed a linear association with coronary artery disease risk in all analyses. Of the three formulae, Williams was the strongest predictor of coronary artery disease. Only age and diabetes duration were stronger predictors. The strength of associations between estimated glucose disposal rate and CAD incidence varied by formula and kidney status.

CONCLUSIONS:

In type 1 diabetes, estimated glucose disposal rates are associated with subsequent coronary artery disease, modulated by kidney disease severity. Future research is merited regarding the clinical usefulness of estimating the glucose disposal rate as a coronary artery disease risk factor and potential therapeutic target.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Glicemia / Doença da Artéria Coronariana / Resistência à Insulina / Biomarcadores / Diabetes Mellitus Tipo 1 País/Região como assunto: Europa Idioma: En Revista: Cardiovasc Diabetol Ano de publicação: 2024 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Glicemia / Doença da Artéria Coronariana / Resistência à Insulina / Biomarcadores / Diabetes Mellitus Tipo 1 País/Região como assunto: Europa Idioma: En Revista: Cardiovasc Diabetol Ano de publicação: 2024 Tipo de documento: Article