Insulin Resistance in Adipose Tissue but Not in Liver Is Associated with Aortic Valve Calcification

Area of Science:

• Cardiovascular Medicine
• Metabolic Syndrome
• Radiology

Background:

• Insulin resistance is implicated in cardiovascular disease pathogenesis.
• The link between insulin resistance and cardiovascular calcification remains unclear.
• Conflicting data exists regarding insulin resistance's role in coronary artery calcification (CAC) and aortic valve calcification (AVC).

Purpose of the Study:

• To investigate the association between hepatic and adipose tissue insulin resistance and the presence of CAC and AVC.
• To determine if insulin resistance in specific tissues contributes to cardiovascular calcification.

Main Methods:

• 1201 subjects without prior coronary heart disease underwent multidetector-computed tomography for CAC and AVC assessment.
• Cardiovascular risk factors, lipid profiles, inflammation markers, glucose, insulin, and free fatty acids were measured.
• Hepatic insulin resistance (HOMA-IR) and adipose tissue insulin resistance (Adipo-IR) indices were calculated.

Main Results:

• A strong correlation was found between HOMA-IR and Adipo-IR (r = 0.758, p < 0.001).
• Higher quartiles of HOMA-IR and Adipo-IR were associated with adverse cardiovascular profiles and increased prevalence of CAC and AVC.
• Adipo-IR in the highest quartile independently predicted higher odds of AVC (OR: 2.40; 95% CI: 1.30-4.43).

Conclusions:

• Adipose tissue insulin resistance (Adipo-IR) is independently associated with aortic valve calcification (AVC).
• Dysfunctional adipose tissue may promote insulin resistance, contributing to AVC development and progression.
• Targeting adipose tissue function could be a strategy for preventing aortic valve calcification.