Titre du document / Document title

Proinsulin concentration is an independent predictor of all-cause and cardiovascular mortality : An 11-year follow-up of the hoorn study

Auteur(s) / Author(s)

ALSSEMA Marjan ⁽¹⁾ ; DEKKER Jacqueline M. ⁽¹⁾ ; NIJPELS Giel ^{(1 2)} ; STEHOUWER Coen D. A. ^{(1 3)} ; BOUTER Lex M. ⁽¹⁾ ; HEINE Robert J. ^{(1 4)} ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

⁽¹⁾ Institute for Research in Extramural Medicine, VU University Medical Center, Amsterdam, PAYS-BAS
⁽²⁾ Department of General Practice, VU University Medical Center, Amsterdam, PAYS-BAS
⁽³⁾ Department of Internal Medicine, Academic Hospital Maastricht, Maastricht, PAYS-BAS
⁽⁴⁾ Department of Endocrinology, VU University Medical Center, Amsterdam, PAYS-BAS

Résumé / Abstract

OBJECTIVE - High proinsulin concentration may be a better predictor for cardiovascular disease (CVD) mortality than insulin concentration. Previous observations may have been confounded by glucose tolerance status or lack of precision because of high intraindividual variability. We investigated the longitudinal relation of means of duplicate measurements of insulin and proinsulin with all-cause and CVD mortality in a population-based cohort taking glucose tolerance status into account. RESEARCH DESIGN AND METHODS- Pasting and post-75-g glucose-load (2-h) glucose, insulin, and proinsulin values were determined in duplicate on separate days in 277 participants with normal glucose metabolism, 208 participants with impaired glucose metabolism, and 119 newly detected patients with type 2 diabetes of the Hoorn Study. Insulin resistance and β-cell function were estimated by homeostasis model assessment (HOMA-IR and HOMA-B, respectively), and the fasting proinsulin-to-insulin ratio was calculated. Subjects were followed with respect to mortality until January 2003. RESULTS- Fasting proinsulin levels were significantly associated with all-cause and CVD mortality. The hazard ratios (HRs) per increase in interquartile range adjusted for age and sex were 1.21 (95% CI 1.04-1.42) for all-cause mortality and 1.33 (1.06-1.66) for CVD mortality. Adjustment for glucose tolerance status and HOMA-IR did not substantially change the associations. CONCLUSIONS- Fasting proinsulin was associated with all-cause and CVD mortality, independent of glucose tolerance status and insulin resistance and largely independent of other CVD risk factors. Proinsulin might play a role in the relationship between insulin resistance and CVD.

Revue / Journal Title

Diabetes care   ISSN 0149-5992   CODEN DICAD2 

Source / Source

2005, vol. 28, n^o4, pp. 860-865 [6 page(s) (article)] (34 ref.)

Langue / Language

Anglais

Editeur / Publisher

American Diabetes Association, Alexandria, VA, ETATS-UNIS  (1978) (Revue)

Mots-clés anglais / English Keywords

Lymphoproliferative syndrome ; Malignant hemopathy ; Prohormone ; Cardiovascular risk ; Acute ; Epidemiology ; Public health ; Pathophysiology ; Human ; Cardiovascular disease ; Follow up study ; Mortality ; Insulin resistance ; Predictive factor ; Proinsulin ;

Mots-clés français / French Keywords

Lymphoprolifératif syndrome ; Hémopathie maligne ; Prohormone ; Risque cardiovasculaire ; Aigu ; Epidémiologie ; Santé publique ; Physiopathologie ; Homme ; Appareil circulatoire pathologie ; Etude longitudinale ; Mortalité ; Insulinoresistance ; Facteur prédictif ; Proinsuline ;

Mots-clés espagnols / Spanish Keywords

Linfoproliferativo síndrome ; Hemopatía maligna ; Prohormona ; Agudo ; Epidemiología ; Salud pública ; Fisiopatología ; Hombre ; Aparato circulatorio patología ; Estudio longitudinal ; Mortalidad ; Resistancia insulina ; Factor predictivo ; Proinsulina ;

Localisation / Location

INIST-CNRS, Cote INIST : 18054, 35400012566106.0160