Abstract 11211: Insulin resistance is a Risk Factor for Ongoing Myocardial Damage in General Subjects: The Takahata Study

Abstract

Background: The presence of metabolic disorder, such as glucose intolerance and dyslipidemia, is associated with the new onset of the cardiovascular disease (CVD) and all cause of mortality. It has been reported that each component of metabolic syndrome (Mets), which includes abdominal obesity, hypertension, impaired insulin tolerance with high fasting glucose levels, and elevated levels of triglycerides, is a risk factor for CVD and ongoing myocardial damage. These findings imply that there is a significant association between the severity of Mets and the existing organ damage. However, correlation between insulin resistance (IR) and cardiac dysfunction in general populations has not been established yet. The purpose of this study is to investigate the association between IR and myocardial damage in general normal subjects.

Methods and Results: We retrospectively studied 2200 consecutive subjects who had been participated in a community-based health check at Takahata town in northern Japan. Mets was evaluated by using the National Cholesterol Education program Adult Treatment Panel III (NCEP-ATP III) criteria. Homeostasis model assessment ratio (HOMA-R) was estimated as suggested presence of IR. Serum level of heart type fatty acid binding protein (H-FABP) was measured as a maker of ongoing myocardial damage. Serum H-FABP level was significantly higher in subjects with Mets and IR than normal subjects. However, there were no significant difference between subjects with IR and those with Mets. To investigate the contribution of IR on ongoing myocardial damage in normal subjects, we excluded 264 subjects with Mets. 1936 subjects without Mets were examined in logistic analysis. In multivariate logistic analysis, presence of IR was independently associated with ongoing myocardial damage (OR: 1.6, 95% confidence interval 1.1 - 2.3). Furthermore, the percentage of ongoing myocardial damage was significantly higher in subjects with IR compared with those without IR.

Conclusion: Presence of IR is related to ongoing myocardial damage in general normal subjects, which suggests that myocardial damage occurs in the early state of metabolic disorder. It is necessary in a future study to find way to ameliorate IR and get better clinical outcomes.