Erschienen in:
01.07.2004 | Article
Plasma insulin and cardiovascular mortality in non-diabetic European men and women: a meta-analysis of data from eleven prospective studies
verfasst von:
The DECODE Insulin Study Group
Erschienen in:
Diabetologia
|
Ausgabe 7/2004
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Abstract
Aims/hypothesis
We examined the association between plasma insulin and cardiovascular mortality in non-diabetic European men and women based on data from eleven prospective studies.
Methods
The study population comprised 6156 men and 5351 women aged 30–89 years. Baseline measurements included oral glucose tolerance test, fasting and 2-h plasma insulin, and conventional risk factors. Cox models were used to calculate hazard ratios (HRs) and their 95% confidence intervals, and overall HRs were assessed by meta-analyses.
Results
During the 8.8-year follow-up, 362 men and 70 women died from cardiovascular disease. The age- and smoking-adjusted overall HR of cardiovascular mortality for the highest vs the lower quartiles of fasting insulin was 1.58 (95% CI: 1.26–1.97) in men and 2.64 (1.54–4.51) in women. Adjusting for other risk factors in addition, the HR was 1.54 (1.16–2.03) in men and 2.66 (1.45–4.90) in women. For 2-h insulin these HRs were 1.28 (0.99–1.66), 1.87 (0.87–4.02), and 0.85 (0.60–1.21), 1.36 (0.53–3.45). The overall HRs for interquartile ranges for fasting and 2-h insulin, with full adjustment, were 1.13 (1.05–1.22) and 1.11 (1.01–1.23) in men, and 1.25 (1.08–1.45) and 1.11 (0.91–1.36) in women.
Conclusions/interpretation
Hyperinsulinaemia, defined by the highest quartile cut-off for fasting insulin, was significantly associated with cardiovascular mortality in both men and women independently of other risk factors. Associations between high 2-h insulin and cardiovascular mortality were weaker and non-significant. Weak positive associations of fasting and 2-h insulin with cardiovascular mortality over interquartile ranges were, however, more similar.