Abstract 14680: Relationship of Insulin Resistance with Impaired Endothelial Function & Coronary Atherosclerosis among High Risk Individuals Enrolled in a Web-Based Lifestyle Intervention Study: Baptist Employee Healthy Heart Study (BEHHS)
Introduction: Insulin resistance (IR) has been implicated in the pathogenesis of vascular dysfunction and consequent atherosclerosis however this relationship has been shown to vary with age, population demographics and cardiometabolic risk. We examined the relationship between IR and endothelial function, and coronary atherosclerosis in a relatively young, high risk population free from known CVD.
Methods: The Baptist Employee Healthy Heart Study (BEHHS) is an ongoing lifestyle intervention study examining the effects of web-based interventions on reducing CVD risk in individuals with metabolic syndrome and type II diabetes mellitus. In addition to administering lifestyle and medical history questionnaires, participants had their Reactive hyperemia index (RHI), a measure endothelial dysfunction (ED) assessed using the EndoPAT 2000 device (Itamar Medical, Israel). Participants older than 35years underwent coronary calcium (CAC) scanning.
Results: The population consisted of 182 participants, 74% women, 49% Hispanic, with a mean age of 52 ± 9 years (range: 34-72 years). RHI was significantly correlated with HOMA-IR (r = -0.17, p=0.02). Individuals with ED (RHI <1.67, 25%) had significantly higher HOMA-IR (3.5 vs. 4.5 p=0.024). There was no significant correlation of CAC with HOMA-IR. After adjusting for likely confounders, IR (HOMA-IR >2.67) was associated with 3-fold increased risk in ED, whereas no such association was noted with CAC presence.
Conclusions: The independent relationship of IR with ED in this high CVD risk population supports the assertion that IR is implicated in the development of vascular disease. However, IR does not appear to be associated with burden of coronary atherosclerosis in relatively young high-risk populations. Nonetheless, our findings stress the importance of assessing the impact of lifestyle interventions on IR and to determine if such reductions are associated with improvement in endothelial function.
Author Disclosures: E. Aneni: None. E. Oni: None. L.L. Roberson: None. J. Post: None. G. Nagi: None. S. Shaharyar: None. O. Jamal: None. S.S. Ali: None. R. Malik: None. M. Aziz: None. A. Younus: None. C. Ye: None. B. Rosell: None. H. Guzman: None. R. Cury: None. J. Fialkow: None. A. Agatston: None. E. Veledar: None. T. Feldman: None. K. Nasir: None.
- © 2014 by American Heart Association, Inc.