Abstract 20207: Effect of Metabolic Syndrome on Incident Peripheral Arterial Disease is Independent of Insulin Resistance: Insights from a Prospective Population Study
Background: Insulin resistance (IR) is believed to have an independent association with adverse cardiovascular (CV) outcomes and may have an mediating effect of the adverse CV effects of metabolic syndrome (MetS). Peripheral arterial disease (PAD) is a marker of systemic atherosclerosis, the prevalence of which increases with aging, and the incidence of which would be expected to higher in those with IR and MetS. Therefore, studied the relationship between MetS, IR and incident PAD in community dwelling adults ≥65 years in the Cardiovascular Health Study (CHS).
Methods: Of the 5795 CHS participants, 4840 were free of baseline PAD (defined by ankle-brachial index >0.9) and had baseline data on fasting serum glucose and insulin levels (and were not taking insulin therapy). MetS was defined using Adult Treatment Panel (ATP) III criteria and IR was defined as homeostasis model assessment (HOMA) IR scores. Cox proportional hazard models were used to estimate associations of MetS and IR with centrally-adjudicated incident PAD during > 12 years of follow-up. The multivariable model was also adjusted for demographics and other CV risk factors including serum inflammatory markers.
Results: Participants had a mean age 73 (±5) years, 58% were women and 13% African American. Overall, 44% had MetS with HOMA-IR tertiles 1, 2, and 3 having 16%, 40% and 75% MetS respectively. Hazard ratios, 95% confidence intervals and p-values for incident PAD associated with MetS and IR are displayed in the Table.
Conclusions: Among community-dwelling older adults free of baseline PAD, MetS was associated with incident PAD that was independent of IR, and other cardiovascular risk factors including serum inflammatory markers. However, IR had no association with incident PAD.
- © 2010 by American Heart Association, Inc.