Sex Differences in the Association Between Insulin Resistance and Incident Coronary Heart Disease and Stroke Among Blacks Without Diabetes Mellitus: The Jackson Heart Study
BackgroundStudies exploring the association between insulin resistance (IR) and cardiovascular disease in blacks have not been conclusive, especially for coronary heart disease (CHD). The McAuley index and homeostasis model assessment of IR (HOMA‐IR) perform differently in predicting cardiovascular...
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| Format: | Article |
| Language: | English |
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Wiley
2017-02-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.116.004229 |
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| author | Valery S. Effoe Lynne E. Wagenknecht Justin B. Echouffo Tcheugui Haiying Chen Joshua J. Joseph Rita R. Kalyani Ronny A. Bell Wen‐Chih H. Wu Ramon Casanova Alain G. Bertoni |
| author_facet | Valery S. Effoe Lynne E. Wagenknecht Justin B. Echouffo Tcheugui Haiying Chen Joshua J. Joseph Rita R. Kalyani Ronny A. Bell Wen‐Chih H. Wu Ramon Casanova Alain G. Bertoni |
| author_sort | Valery S. Effoe |
| collection | DOAJ |
| description | BackgroundStudies exploring the association between insulin resistance (IR) and cardiovascular disease in blacks have not been conclusive, especially for coronary heart disease (CHD). The McAuley index and homeostasis model assessment of IR (HOMA‐IR) perform differently in predicting cardiovascular disease. We investigated this association in the Jackson Heart Study, a large longitudinal cohort of blacks. Methods and ResultsIR was estimated for 3565 participants without diabetes mellitus and cardiovascular disease at baseline using the McAuley index and HOMA‐IR, and their associations with incident CHD and stroke (composite outcome) were compared. A lower McAuley index and higher HOMA‐IR are indicative of IR. Cox regression analysis was used to estimate adjusted hazard ratios for incident CHD and/or stroke. There were 158 events (89 CHD‐only, 58 stroke‐only, and 11 CHD/stroke) over a median follow‐up of 8.4 years. After adjustment for demographic factors, the risk of the composite outcome decreased with each SD increase in the McAuley index (hazard ratio 0.80; 95% CI: 0.67–0.96), with no attenuation after further accounting for CHD and stroke risk factors. When considered individually, McAuley index and HOMA‐IR were associated with CHD (hazard ratio 0.71, 95% CI: 0.55–0.92 and hazard ratio 1.33, 95% CI: 1.03–1.72, respectively), but not stroke risk. The logHOMA‐IR and CHD association was present in men, but not in women (Pinteraction=0.01). ConclusionsBoth HOMA‐IR and the McAuley index demonstrate strong associations with CHD but not stroke risk in blacks. The logHOMA‐IR and CHD association was present in men, but not in women. |
| first_indexed | 2024-12-13T12:26:13Z |
| format | Article |
| id | doaj.art-3d0c675cabac4a7b803b678a482b6c7f |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-12-13T12:26:13Z |
| publishDate | 2017-02-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-3d0c675cabac4a7b803b678a482b6c7f2022-12-21T23:46:18ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802017-02-016210.1161/JAHA.116.004229Sex Differences in the Association Between Insulin Resistance and Incident Coronary Heart Disease and Stroke Among Blacks Without Diabetes Mellitus: The Jackson Heart StudyValery S. Effoe0Lynne E. Wagenknecht1Justin B. Echouffo Tcheugui2Haiying Chen3Joshua J. Joseph4Rita R. Kalyani5Ronny A. Bell6Wen‐Chih H. Wu7Ramon Casanova8Alain G. Bertoni9Division of General Internal Medicine, Morehouse School of Medicine, Atlanta, GADepartment of Epidemiology and Prevention, Wake Forest School of Medicine, Winston Salem, NCBrigham and Women's Hospital, Harvard Medical School, Boston, MADepartment of Biostatistical Sciences, Wake Forest School of Medicine, Winston Salem, NCDivision of Endocrinology, Diabetes and Metabolism, Johns Hopkins University School of Medicine, Baltimore, MDDepartment of Medicine, Johns Hopkins Medical Institutions, Baltimore, MDDepartment of Epidemiology and Prevention, Wake Forest School of Medicine, Winston Salem, NCDepartment of Medicine, Alpert Medical School of Brown University, Providence, RIDepartment of Biostatistical Sciences, Wake Forest School of Medicine, Winston Salem, NCDepartment of Epidemiology and Prevention, Wake Forest School of Medicine, Winston Salem, NCBackgroundStudies exploring the association between insulin resistance (IR) and cardiovascular disease in blacks have not been conclusive, especially for coronary heart disease (CHD). The McAuley index and homeostasis model assessment of IR (HOMA‐IR) perform differently in predicting cardiovascular disease. We investigated this association in the Jackson Heart Study, a large longitudinal cohort of blacks. Methods and ResultsIR was estimated for 3565 participants without diabetes mellitus and cardiovascular disease at baseline using the McAuley index and HOMA‐IR, and their associations with incident CHD and stroke (composite outcome) were compared. A lower McAuley index and higher HOMA‐IR are indicative of IR. Cox regression analysis was used to estimate adjusted hazard ratios for incident CHD and/or stroke. There were 158 events (89 CHD‐only, 58 stroke‐only, and 11 CHD/stroke) over a median follow‐up of 8.4 years. After adjustment for demographic factors, the risk of the composite outcome decreased with each SD increase in the McAuley index (hazard ratio 0.80; 95% CI: 0.67–0.96), with no attenuation after further accounting for CHD and stroke risk factors. When considered individually, McAuley index and HOMA‐IR were associated with CHD (hazard ratio 0.71, 95% CI: 0.55–0.92 and hazard ratio 1.33, 95% CI: 1.03–1.72, respectively), but not stroke risk. The logHOMA‐IR and CHD association was present in men, but not in women (Pinteraction=0.01). ConclusionsBoth HOMA‐IR and the McAuley index demonstrate strong associations with CHD but not stroke risk in blacks. The logHOMA‐IR and CHD association was present in men, but not in women.https://www.ahajournals.org/doi/10.1161/JAHA.116.004229blackscardiovascular disease risk factorscerebrovascular disease/strokecoronary heart diseaseepidemiologyinsulin resistance |
| spellingShingle | Valery S. Effoe Lynne E. Wagenknecht Justin B. Echouffo Tcheugui Haiying Chen Joshua J. Joseph Rita R. Kalyani Ronny A. Bell Wen‐Chih H. Wu Ramon Casanova Alain G. Bertoni Sex Differences in the Association Between Insulin Resistance and Incident Coronary Heart Disease and Stroke Among Blacks Without Diabetes Mellitus: The Jackson Heart Study Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease blacks cardiovascular disease risk factors cerebrovascular disease/stroke coronary heart disease epidemiology insulin resistance |
| title | Sex Differences in the Association Between Insulin Resistance and Incident Coronary Heart Disease and Stroke Among Blacks Without Diabetes Mellitus: The Jackson Heart Study |
| title_full | Sex Differences in the Association Between Insulin Resistance and Incident Coronary Heart Disease and Stroke Among Blacks Without Diabetes Mellitus: The Jackson Heart Study |
| title_fullStr | Sex Differences in the Association Between Insulin Resistance and Incident Coronary Heart Disease and Stroke Among Blacks Without Diabetes Mellitus: The Jackson Heart Study |
| title_full_unstemmed | Sex Differences in the Association Between Insulin Resistance and Incident Coronary Heart Disease and Stroke Among Blacks Without Diabetes Mellitus: The Jackson Heart Study |
| title_short | Sex Differences in the Association Between Insulin Resistance and Incident Coronary Heart Disease and Stroke Among Blacks Without Diabetes Mellitus: The Jackson Heart Study |
| title_sort | sex differences in the association between insulin resistance and incident coronary heart disease and stroke among blacks without diabetes mellitus the jackson heart study |
| topic | blacks cardiovascular disease risk factors cerebrovascular disease/stroke coronary heart disease epidemiology insulin resistance |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.116.004229 |
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