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

Dis Markers. 2016:2016:9085474. doi: 10.1155/2016/9085474. Epub 2016 Dec 29.

Abstract

Background. Insulin resistance is involved in the pathogenesis of cardiovascular disease, but its relationship with cardiovascular calcification has yielded conflicting results. The purpose of the present study was to investigate the role of hepatic and adipose tissue insulin resistance on the presence of coronary artery (CAC > 0) and aortic valve calcification (AVC > 0). Methods. In 1201 subjects (52% women, 53.6 ± 9.3 years old) without familiar and personal history of coronary heart disease, CAC and AVC were assessed by multidetector-computed tomography. Cardiovascular risk factors were documented and lipid profile, 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. Results. There was a significant relationship between HOMA-IR and Adipo-IR indices (r = 0.758, p < 0.001). Participants in the highest quartiles of HOMA-IR and Adipo-IR indices had a more adverse cardiovascular profile and higher prevalence of CAC > 0 and AVC > 0. After full adjustment, subjects in the highest quartile of Adipo-IR index had higher odds of AVC > 0 (OR: 2.40; 95% CI: 1.30-4.43), as compared to those in the lowest quartile. Conclusions. Adipo-IR was independently associated with AVC > 0. This suggests that abnormal adipose tissue function favors insulin resistance that may promote the development and progression of AVC.

MeSH terms

  • Adipose Tissue / metabolism*
  • Adipose Tissue / pathology
  • Adult
  • Aortic Valve / diagnostic imaging
  • Aortic Valve / metabolism*
  • Aortic Valve / pathology*
  • Aortic Valve Stenosis / diagnostic imaging
  • Aortic Valve Stenosis / metabolism*
  • Aortic Valve Stenosis / pathology
  • Blood Glucose / metabolism
  • Calcinosis / diagnostic imaging
  • Calcinosis / metabolism*
  • Calcinosis / pathology
  • Cholesterol, LDL / blood
  • Coronary Artery Disease / diagnostic imaging
  • Coronary Artery Disease / metabolism*
  • Coronary Artery Disease / pathology
  • Coronary Vessels / diagnostic imaging
  • Coronary Vessels / metabolism*
  • Coronary Vessels / pathology
  • Fatty Acids, Nonesterified / blood
  • Female
  • Humans
  • Insulin / blood
  • Insulin Resistance*
  • Liver / metabolism
  • Male
  • Middle Aged
  • Risk Factors
  • Tomography, X-Ray Computed
  • Triglycerides / blood

Substances

  • Blood Glucose
  • Cholesterol, LDL
  • Fatty Acids, Nonesterified
  • Insulin
  • Triglycerides

Supplementary concepts

  • Aortic Valve, Calcification of