@article{3089958,
    title = "Fasting insulin has a stronger association with an adverse cardiometabolic risk profile than insulin resistance: The RISC study",
    author = "De Rooij, S.R. and Dekker, J.M. and Kozakova, M. and Mitrakou, A. and Melander, O. and Gabriel, R. and Guidone, C. and Højlund, K. and Murphy, M.S. and Nijpels, G. and Dekker, J. and De Rooij, S. and Nijpels, G. and Boorsma, W. and Mitrakou, A. and Tournis, S. and Kyriakopoulou, K. and Thomakos, P. and Lalic, N. and Lalic, K. and Jotic, A. and Lukic, L. and Civcic, M. and Nolan, J. and Yeow, T.P. and Murphy, M. and DeLong, C. and Neary, G. and Colgan, M.P. and Hatunic, M. and Konrad, T. and Böhles, H. and Fuellert, S. and Baer, F. and Zuchhold, H. and Golay, A. and Harsch Bobbioni, E. and Barthassat, V. and Makoundou, V. and Lehmann, T.N.O. and Merminod, T. and Petrie, J.R. and Perry, C. and Neary, F. and MacDougall, C. and Shields, K. and Malcolm, L. and Laakso, M. and Salmenniemi, U. and Aura, A. and Raisanen, R. and Ruotsalainen, U. and Sistonen, T. and Laitinen, M. and Saloranta, H. and Coppack, S.W. and McIntosh, N. and Ross, J. and Pettersson, L. and Khadobaksh, P. and Laville, M. and Bonnet, F. and Brac De La Perriere, A. and Louche-Pelissier, C. and Maitrepierre, C. and Peyrat, J. and Beltran, S. and Serusclat, A. and Gabriel, R. and Sánchez, M.E. and Carraro, R. and Friera, A. and Perez, S. and Nilsson, P. and Persson, M. and Östling, G. and Melander, O. and Burri, P. and Piatti, P.M. and Monti, L.D. and Setola, E. and Galluccio, E. and Minicucci, F. and Colleluori, A. and Walker, M. and Ibrahim, I.M. and Jayapaul, M. and Carman, D. and Ryan, C. and Short, K. and McGrady, Y. and Richardson, D. and Beck-Nielsen, H. and Staehr, P. and Hojlund, K. and Vestergaard, V. and Olsen, C. and Hansen, L. and Bolli, G.B. and Porcellati, F. and Fanelli, C. and Lucidi, P. and Calcinaro, F. and Saturni, A. and Ferrannini, E. and Natali, A. and Muscelli, E. and Pinnola, S. and Kozakova, M. and Mingrone, G. and Guidone, C. and Favuzzi, A. and Di Rocco, P. and Anderwald, C. and Bischof, M. and Promintzer, M. and Krebs, M. and Mandl, M. and Hofer, A. and Luger, A. and Waldhäusl, W. and Roden, M. and Balkau, B. and Coppack, S.W. and Dekker, J.M. and Ferrannini, E. and Mari, A. and Walker, M. and Gaffney, P. and Nolan, J. and Boran, G. and Olsen, C. and Hansen, L. and Beck-Nielsen, H. and Kok, A. and Dekker, J. and Patel, S. and Walker, M. and Gastaldelli, A. and Ciociaro, D. and Kozakova, M. and Guillanneuf, M.T. and Balkau, B. and Mhamdi, L. and Balkau, B. and Balkau, B. and Mari, A. and Mhamdi, L. and Landucci, L. and Hills, S. and Mota, L. and Mari, A. and Pacini, G. and Cavaggion, C. and Hills, S.A. and Landucci, L. and Mota, L.",
    journal = "European Journal of Endocrinology",
    year = "2009",
    volume = "161",
    number = "2",
    pages = "223-230",
    publisher = "BioScientifica Ltd",
    issn = "0804-4643, 1479-683X",
    doi = "10.1530/EJE-09-0058",
    keywords = "insulin;  insulin, adult;  arterial wall thickness;  article;  atherosclerosis;  cardiovascular disease;  cardiovascular risk;  cohort analysis;  controlled study;  diet restriction;  disease association;  echography;  female;  glucose clamp technique;  human;  hyperinsulinemia;  insulin resistance;  insulin sensitivity;  major clinical study;  male;  metabolic syndrome X;  oral glucose tolerance test;  prevalence;  priority journal;  sex difference;  blood;  cardiovascular disease;  clinical trial;  diet restriction;  Europe;  glucose tolerance test;  insulin resistance;  metabolic syndrome X;  metabolism;  middle aged;  multicenter study;  physiology;  tunica media, Adult;  Cardiovascular Diseases;  Cohort Studies;  Europe;  Fasting;  Female;  Glucose Clamp Technique;  Glucose Tolerance Test;  Humans;  Insulin;  Insulin Resistance;  Male;  Metabolic Syndrome X;  Middle Aged;  Prevalence;  Tunica Media",
    abstract = "Objective: Fasting insulin concentrations are often used as a surrogate measure of insulin resistance. We investigated the relative contributions of fasting insulin and insulin resistance to cardiometabolic risk and preclinical atherosclerosis. Design and methods: The Relationship between Insulin Sensitivity and Cardiovascular disease (RISC) cohort consists of 1326 European non-diabetic, overall healthy men and women aged 30-60 years. We performed standard oral glucose tolerance tests and hyperinsulinemic euglycemic clamps. As a general measure of cardiovascular risk, we assessed the prevalence of the metabolic syndrome in 1177 participants. Carotid artery intima media thickness (IMT) was measured by ultrasound to assess preclinical atherosclerosis. Results: Fasting insulin was correlated with all elements of the metabolic syndrome. Insulin sensitivity (M/I) was correlated with most elements. The odds ratio for the metabolic syndrome of those in the highest quartile of fasting insulin compared with those in the lower quartiles was 5.4 (95% confidence interval (CI) 2.8-10.3, adjusted for insulin sensitivity) in men and 5.1 (2.6-9.9) in women. The odds ratio for metabolic syndrome of those with insulin sensitivity in the lowest quartile of the cohort compared with those in the higher quartiles was 2.4 (95% CI 1.3-4.7, adjusted for fasting insulin) in men and 1.6 (0.8-3.1) in women. Carotid IMT was only statistically significantly associated with fasting insulin in both men and women. Conclusions: Fasting insulin, a simple and practical measure, may be a stronger and independent contributor to cardiometabolic risk and atherosclerosis in a healthy population than hyperinsulinemic euglycemic clamp-derived insulin sensitivity. © 2009 European Society of Endocrinology."
}