Insulin resistance, hyperinsulinemia may predict aortic stenosis in men
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Key takeaways:
- Biomarkers reflecting hyperinsulinemia and/or insulin resistance independently predicted aortic stenosis in men.
- These results suggest insulin resistance is important in the pathogenesis of aortic stenosis.
Hyperinsulinemia and/or insulin resistance biomarkers, such as fasting, plasma insulin and proinsulin, predicted aortic stenosis, independent of other cardiovascular risk factors, according to study results published in Annals of Medicine.
“Presumably, several factors interact with the initiation and progression of the disease in the pathogenesis of aortic stenosis,” Johanna Kuusisto, MD, chief physician at Kuopio University Hospital and professor of medicine at the University of Eastern Finland, in Kuopio, Finland, and colleagues wrote. “To find a means for early prevention of aortic stenosis, it is crucial to identify how different factors contribute to the disease process. However, there have been no studies on large panels of biomarkers as risk factors for aortic stenosis.”
Kuusisto and colleagues conducted a large-scale population-based follow-up study using data from 10,144 Finnish men without aortic stenosis from the Metabolic Syndrome in the Men study. Researchers identified variables predicting aortic stenosis over 10.8 years of follow-up.
Overall, 1.1% of men had aortic stenosis (median age, 62 years).
Fasting (HR = 1.44; 95% CI, 1.23-1.68), 30-minute (HR = 1.43; 95% CI, 1.17-1.74) and 120-minute plasma insulin (HR = 1.38; 95% CI, 1.12-1.69) and fasting (HR = 1.4; 95% CI, 1.2-1.65), 30-minute (HR = 1.44; 95% CI, 1.18-1.76) and 120-minute plasma proinsulin (HR = 1.39; 95% CI, 1.13-1.71) were all associated with incident aortic stenosis. In addition, Matsuda index (HR = 0.68; 95% CI, 0.56-0.82) and serum C-peptide (HR = 1.47; 95% CI, 1.22-1.77) were also associated with incident aortic stenosis along with age, systolic blood pressure, BMI, waist circumference, waist/hip ratio, height, body fat mass, fat-free mass and high-sensitivity C-reactive protein.
The results remained significant after adjustments.
Principal component analyses demonstrated that fasting plasma insulin, C-peptide, Matsuda index, waist/hip ratio, urine albumin excretion, age, body fat mass and systolic BP were all significantly associated with aortic stenosis.
“This novel finding highlights that insulin resistance may be a significant and modifiable risk factor for [aortic stenosis],” Kuusisto said in a press release. “As insulin resistance is common in Western populations, managing metabolic health could be a new approach to reduce the risk of [aortic stenosis] and improve cardiovascular health in aging populations. Future studies are now warranted to determine whether improving insulin sensitivity through measures such as weight control and exercise can help prevent the condition.”
Reference:
- World’s most common heart valve disease linked to insulin resistance in large national study. https://newsroom.taylorandfrancisgroup.com/worlds-most-common-heart-valve-disease-linked-to-insulin-resistance-in-large-national-study. Published Nov. 27, 2024. Accessed Nov. 27, 2024.
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