Abstract 17221: The Association of Metabolic Syndrome and Insulin Resistance with Incident Heart Failure is Independent of Each Other and Other Risk Factors including C-Reactive Protein
Background: Insulin resistance (IR) is an important underlying pathophysiologic basis for the adverse cardiovascular (CV) outcomes associated with metabolic syndrome (MetS). However, recent evidence suggests that the association between IR and MetS may be more complex. We tested the hypothesis that MetS and IR would increase the risk of incident heart failure (HF) independent of each other.
Methods: Of the 5795 community-dwelling adults ≥65 years in the Cardiovascular Health Study, 5304 were free of heart failure (HF), not taking insulin therapy and had baseline data on fasting serum glucose and insulin levels. MetS was defined using Adult Treatment Panel (ATP) III criteria and IR was defined as calculated using fasting glucose and insulin levels and expressed in homeostasis model assessment (HOMA) IR scores. Cox proportional hazard models were used to estimate associations of MetS and IR with centrally-adjudicated incident HF during over 12 years of follow-up. The multivariable model was also adjusted for demographics and other CV risk factors including C-reactive protein.
Results: Participants had a mean age 73 (±6) years, 58% were women, 14% African American, and 44% had MetS. The prevalence of MetS increased with increasing HOMA-IR score tertiles: 16%, 41% and 75% for IR tertiles 1, 2 and 3 respectively. Incident HF occurred in 24% and 17% of those with and without MetS, and 17%, 20% and 24% for those with IR tertiles 1, 2 and 3 respectively. Hazard ratio, 95% confidence intervals and p-values for incident HF associated with MetS and IR are displayed in the Table.
Conclusions: Among community-dwelling older adults free of baseline HF, both MetS and IR were associated with incident HF, which was independent of each other and other risk factors including C-reactive protein.
- © 2010 by American Heart Association, Inc.