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Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response.  Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Adult, Aged, Asian Continental Ancestry Group, Blood Pressure, Body Mass Index, Cardiovascular Diseases, Cholesterol, Cross-Sectional Studies, Diabetes Mellitus, Type 2, Female, Glucose Tolerance Test, Humans, India, Insulin Resistance, Male, Metabolic Syndrome, Middle Aged, Population Surveillance, Prevalence, Risk Factors, Rural Population, Surveys and Questionnaires, Triglycerides, Young Adult.
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Is insulin resistance associated with increased cardiovascular risk in Asian Indians with normal glucose tolerance -- the Chennai Urban Rural Epidemiology Study ( CURES-66 )? Context: The aim of the study was to assess the association of Insulin Resistance [IR] assessed by Homeostasis Assessment model (HOMA-IR) with cardiovascular risk factors in subjects with Normal Glucose Tolerance [NGT] in Asian Indians. This cross-sectional study recruited subjects from the Chennai Urban Rural Epidemiology Study [CURES] an epidemiological study in a representative population of Chennai [formerly Madras], in South India. We included 1550 subjects with normal glucose tolerance, ie, fasting plasma glucose < 100 mg/dl [5.6 mmol/L] and 2 hour post load plasma glucose < 140 mg/dl [7.8 mmol/L]. IR was calculated using the homeostasis assessment model (HOMA-IR) using the formula: fasting insulin (1IU/mL) fasting glucose (mmol/L)/22.5. Metabolic syndrome [MS] was defined based on modified Adult Treatment Panel III (ATP III) guidelines. HOMA-IR was found to be significantly associated with systolic blood pressure (beta = 0.100, p < 0.001), diastolic pressure (beta = 0.094, p < 0.001), total cholesterol (beta = 0.068, p = 0.005), serum triglycerides (beta = 0.105, p < 0.001), LDL cholesterol (beta = 0.118, p < 0.005), and HDL cholesterol (beta = -0.060, p < 0.001) even after adjusting age, gender and BMI. Subjects with family history of type 2 diabetes had significantly higher HOMA-IR [p = 0.011] compared to those without family history. In relation to physical activity, subjects with heavy grade activity had significantly lower HOMA-IR values compared to the light grade activity [p < 0.001] Subjects with generalized obesity [p < 0.001] and abdominal obesity [p < 0.001] had significantly higher HOMA-IR which remained statistically significant even after adjusting for age and gender. There was a linear increase in the mean values of HOMA IR with increase in number of components of MS [p for trend < 0.001]
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Among Asian Indians who are known to have high risk of premature coronary artery disease and diabetes, a significant association exists between insulin resistance with cardiovascular risk factors even among NGT subjects. Final Decision: yes