Association between insulin resistance and arterial stiffness in Mexican patients without type 2 diabetes

Central aortic arterial stiffness (CAAS) is an independent cardiovascular risk factor. Insulin resistance (IR) contributes to CAAS-associated risk.

To evaluate the association between IR and CAAS in a Mexican population without diabetes.

IR was estimated with Homeostatic Model Assessment 2-Insulin Resistance (HOMA2-IR) and other surrogate markers (Metabolic score for IR [METS-IR], Quantitative Insulin Sensitivity Check Index [QUICKI], triglycerides/glucose index [TyG], TyG*body mass index [TyG*BMI] and triglycerides/high-density lipoprotein cholesterol ratio [TG/HDL-C]). CAAS was evaluated using carotid-femoral pulse wave velocity analysis (PWV_cf) and the standardized augmentation index (AI-75). Bivariate correlations were made between surrogate markers and PWV_cf. Increased CAAS was defined as PWV_cf above the 90^th percentile. Thresholds and area under the curve (AUC) were obtained for each surrogate marker in order to evaluate their performance in estimating increased CAAS.

Three hundred and fifty-eight patients were included. A correlation was found between HOMA2-IR and PWV_cf; this correlation was replicated with other surrogate markers. METS-IR and TyG*BMI had the highest degree of correlation with PWV_cf. When adjustments were made for covariates, the correlations with TyG*BMI, METS-IR, HOMA2-IR and QUICKI maintained significance. HOMA2-IR showed the strongest correlation with AI-75. METS-IR and TyG showed the best AUC. Patients with prediabetes had the highest PWV_cf.

The relationship between IR and CAAS is present before the onset of diabetes; this association may entail higher cardiovascular risk.