Korean J Epidemiol.  2007 Jun;29(1):46-58.

The association between insulin resistance and Framingham risk score among type 2 diabetes

Affiliations
  • 1Graduate School of Public Health, Yonsei University, Institute for Health Promotion. jsunha@yumc.yonsei.ac.kr
  • 2Korean Metabolic Syndrome Research Initiatives.
  • 3College of medicine, Pochon Cha University.
  • 4Yonsei University College of Medicine.
  • 5Ajou University School of Medicine.
  • 6National Health Insurance Medical Center.
  • 7Huh's Diabetes Center.

Abstract

BACKGROUND AND PURPOSE: Insulin resistance has been known to be associated with the risk of cardiovascular diseases. However, the relationship with Framingham risk score among type 2 diabetes has not been well known. We investigated the relationship between insulin resistance (IR) and the Framingham risk score(FRS) among type 2 diabetes in Korea.
METHODS
We estimated the 5-year risk of ischemic heart disease(IHD) based on Framingham equation among 1,941 diabetes patients(1,294 men and 647 women), who visited Huh's clinic, enrolled from January 2003 to June 2006. IR, which was measured by insulin tolerance test (ITT), was divided into five groups(Q1 to Q5). High risk of IHD was defined as upper 10 percentile of FRS. Multivariate regression and logistic regression models were used to see independent association of higher quintiles of IR level, compared with lowest quintile(Q1) for the risk of IHD.
RESULTS
Mean (+/-standard deviation) 5-year FRS of study subjects were 8.40%(+/-6.89) for men and 5.92%(+/-5.23) for women. There were significant correlation between IR, body mass index, HbA1C, fasting glucose, triglyceride, LDL-cholesterol, C-peptide and FRS in both men and women. After adjusting for triglyceride, LDL-cholesterol, C-peptide, multivariate regression model analysis showed that IR was independently associated with the FRS. A positive association between IR and high risk of IHD was observed in men: highest versus lowest quintile of IR (odds ratio 5.45 in men and 4.71 in women).
CONCLUSION
Increased IR level was independently associated with risk of IHD measured by FRS among type 2 diabetes in Korea.

Keyword

type 2 diabetes; insulin resistance; Framingham score; ischemic heart disease
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