| Insulin resistance and the relationship of a dyslipidemia to coronary heart disease: the Framingham Heart Study. | |
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MedLine Citation:
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PMID: 21311041 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: The goal of this study was to examine the effect of insulin resistance (IR) in subjects without diabetes on the relationship of a dyslipidemia with high triglycerides and low high-density lipoprotein cholesterol (HDL-C) to the development of coronary heart disease (CHD). METHODS AND RESULTS: Lower and higher fasting plasma HDL-C and triglyceride concentrations (defined at the study population median) and presence or absence of IR (defined by upper quartile Homeostatic Model Assessment values) were related to the development of myocardial infarction or CHD death in Framingham Heart Study participants without diabetes or a history of CHD (n=2910) attending the 1991 to 1995 examination. During follow-up (mean, 14 years), 128 participants experienced an incident CHD event. With Kaplan-Meier plots, the incidence of CHD was significantly greater with than without IR at either the lowest HDL-C or the highest triglycerides (P<0.001). In multivariable Cox models adjusted for major CHD risk factors, including waist circumference, only subgroups with IR had a significantly higher incidence of CHD. Compared with a reference group without IR and with higher-than-median HDL-C or lower-than-median triglycerides, the hazard ratio (HR) for incident events was significant with only IR and a lower HDL-C (HR 2.83, P<0.001) or higher triglycerides (HR 2.50, P<0.001). These findings were similar in men and women. CONCLUSIONS: In this community-based sample exclusive of diabetes, incident CHD risk associated with plasma HDL-C or triglycerides was significantly increased only in the presence of IR. |
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Authors:
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Sander J Robins; Asya Lyass; Justin P Zachariah; Joseph M Massaro; Ramachandran S Vasan |
Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural Date: 2011-02-10 |
Journal Detail:
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Title: Arteriosclerosis, thrombosis, and vascular biology Volume: 31 ISSN: 1524-4636 ISO Abbreviation: Arterioscler. Thromb. Vasc. Biol. Publication Date: 2011 May |
Date Detail:
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Created Date: 2011-04-21 Completed Date: 2011-06-24 Revised Date: 2012-05-02 |
Medline Journal Info:
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Nlm Unique ID: 9505803 Medline TA: Arterioscler Thromb Vasc Biol Country: United States |
Other Details:
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Languages: eng Pagination: 1208-14 Citation Subset: IM |
Affiliation:
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Framingham Heart Study, 73 Mount Wayte Ave, Ste 2, Framingham, MA 01702-5803, USA. sjrobins@bu.edu |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Biological Markers / blood Blood Glucose / metabolism Chi-Square Distribution Cholesterol, HDL / blood* Coronary Disease / blood, epidemiology*, physiopathology Dyslipidemias / blood, epidemiology*, physiopathology Female Humans Incidence Insulin / blood* Insulin Resistance* Kaplan-Meier Estimate Male Massachusetts / epidemiology Middle Aged Prevalence Proportional Hazards Models Risk Assessment Risk Factors Time Factors Triglycerides / blood* |
| Grant Support | |
ID/Acronym/Agency:
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N01 HC025195/HC/NHLBI NIH HHS; N01-HC-25195/HC/NHLBI NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Biological Markers; 0/Blood Glucose; 0/Cholesterol, HDL; 0/Insulin; 0/Triglycerides |
| Comments/Corrections | |
Comment In:
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Arterioscler Thromb Vasc Biol. 2011 May;31(5):954-5
[PMID:
21508339
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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