The Association of Insulin Sensitivity, Secretion, and Clearance With Subclinical Atherosclerosis in Middle-Aged Adults Without Diabetes: A Cross-Sectional Analysis of the SCAPIS Cohort

IF 3.7 2区医学 Q2 ENDOCRINOLOGY & METABOLISM

Journal of Diabetes Pub Date : 2025-10-19 DOI:10.1111/1753-0407.70161

Rebecka Renklint, Per Liv, Ioannis Katsoularis, Tommy Olsson, Julia Otten

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引用次数: 0

Abstract

Object

Type 2 diabetes (T2D) is an established risk factor for cardiovascular disease (CVD), with increased risk already observed in the prediabetic state. This study aimed to investigate the association of insulin sensitivity, secretion, and clearance with subclinical atherosclerosis in a randomly selected cohort of Swedish adults aged 50–64 years without known diabetes.

Material and Methods

For this cross-sectional analysis, data from the Umeå site of the Swedish CArdioPulmonary BioImage Study (SCAPIS) were used, which included 2507 individuals aged 50–64 years. After applying exclusion criteria, 2054 participants remained. Insulin sensitivity, secretion, and clearance were calculated using an oral glucose tolerance test (OGTT). Atherosclerosis was assessed by coronary computed tomography angiography (CCTA) and carotid ultrasound, yielding coronary artery calcification scores (CACS), coronary segment involvement scores (SIS), and total carotid plaque counts. Ordinal regression models analyzed associations between insulin measures and atherosclerosis, adjusting for cardiovascular risk factors.

Results

Lower insulin sensitivity, as measured by the GUTT index, was associated with higher CACS and SIS, but not with carotid plaque count. No significant relationship was found between insulin secretion (Insulinogenic Index) and any atherosclerotic marker. Reduced insulin clearance was associated with CACS and SIS in unadjusted analyses; however, these associations did not persist after multivariable adjustment.

Conclusion

In individuals without diabetes, insulin resistance is associated with markers of subclinical coronary atherosclerosis, reinforcing its role in early CVD. Insulin secretion or clearance are not directly associated with measures of subclinical atherosclerosis in this population but may contribute indirectly via effects on circulating insulin levels.

Abstract Image

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无糖尿病中年人胰岛素敏感性、分泌和清除率与亚临床动脉粥样硬化的关系：SCAPIS队列的横断面分析

2型糖尿病（T2D）是心血管疾病（CVD）的危险因素，在糖尿病前期已经观察到风险增加。这项研究旨在调查胰岛素敏感性、分泌和清除与亚临床动脉粥样硬化的关系，研究对象是随机选择的50-64岁无糖尿病的瑞典成年人。材料和方法本横断面分析的数据来自瑞典心肺生物图像研究（SCAPIS），其中包括2507名年龄在50-64岁之间的个体。在应用排除标准后，仍有2054名参与者。使用口服葡萄糖耐量试验（OGTT）计算胰岛素敏感性、分泌和清除率。通过冠状动脉计算机断层血管造影（CCTA）和颈动脉超声评估动脉粥样硬化，得出冠状动脉钙化评分（CACS）、冠状动脉段累及评分（SIS）和总颈动脉斑块计数。顺序回归模型分析了胰岛素测量和动脉粥样硬化之间的关系，调整了心血管危险因素。结果通过GUTT指数测量的胰岛素敏感性较低与较高的CACS和SIS相关，但与颈动脉斑块计数无关。胰岛素分泌（胰岛素生成指数）与任何动脉粥样硬化标志物之间没有明显关系。在未经调整的分析中，胰岛素清除率降低与CACS和SIS相关；然而，这些关联在多变量调整后并没有持续存在。结论在没有糖尿病的个体中，胰岛素抵抗与亚临床冠状动脉粥样硬化标志物相关，加强了其在早期CVD中的作用。胰岛素分泌或清除与亚临床动脉粥样硬化的测量没有直接关系，但可能通过对循环胰岛素水平的影响间接起作用。

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来源期刊

Journal of Diabetes ENDOCRINOLOGY & METABOLISM-

CiteScore

6.50

自引率

2.20%

发文量

审稿时长

>12 weeks

期刊介绍： Journal of Diabetes (JDB) devotes itself to diabetes research, therapeutics, and education. It aims to involve researchers and practitioners in a dialogue between East and West via all aspects of epidemiology, etiology, pathogenesis, management, complications and prevention of diabetes, including the molecular, biochemical, and physiological aspects of diabetes. The Editorial team is international with a unique mix of Asian and Western participation. The Editors welcome submissions in form of original research articles, images, novel case reports and correspondence, and will solicit reviews, point-counterpoint, commentaries, editorials, news highlights, and educational content.