BACKGROUND Insulin resistance may contribute to aortic stiffening that leads to end-organ damage. We examined the cross-sectional association and prospective association of insulin resistance and aortic stiffness in older adults without diabetes. METHODS We analyzed 2571 men and women at Visit 5 (in 2011-2013), and 2350 men and women at repeat examinations from baseline at Visit 1 (in 1987-1989) to Visit 5 (in 2011-2013). Linear regression was used to estimate the difference in aortic stiffness per standard unit of HOMA-IR, TG/HDL-C, and TyG at Visit 5. Linear mixed effects were used to assess if high, as opposed to non-high, aortic stiffness (> 75th percentile) was preceded by a faster annual rate of change in log-HOMA-IR, log-TG/HDL-C, and log-TyG from Visit 1 to Visit 5. RESULTS The mean age of participants was 75 years, 37% (n = 957) were men, and 17% (n = 433) were African American. At Visit 5, higher HOMA-IR, higher TG/HDL-C, and higher TyG were associated with higher aortic stiffness (16 cm/s per SD (95% CI 6, 27), 29 cm/s per SD (95% CI 18, 40), and 32 cm/s per SD (95% CI 22, 42), respectively). From Visit 1 to Visit 5, high aortic stiffness, compared to non-high aortic stiffness, was not preceded by a faster annual rate of change in log-HOMA-IR from baseline to 9 years (0.030 (95% CI 0.024, 0.035) vs. 0.025 (95% CI 0.021, 0.028); p = 0.15) or 9 years onward (0.011 (95% CI 0.007, 0.015) vs. 0.011 (95% CI 0.009, 0.013); p = 0.31); in log-TG/HDL-C from baseline to 9 years (0.019 (95% CI 0.015, 0.024) vs. 0.024 (95% CI 0.022, 0.026); p = 0.06) or 9 years onward (- 0.007 (95% CI - 0.010, - 0.005) vs. - 0.009 (95% CI - 0.010, - 0.007); p = 0.08); or in log-TyG from baseline to 9 years (0.002 (95% CI 0.002, 0.003) vs. 0.003 (95% CI 0.003, 0.003); p = 0.03) or 9 years onward (0 (95% CI 0, 0) vs. 0 (95% CI 0, 0); p = 0.08). CONCLUSIONS Among older adults without diabetes, insulin resistance was associated with aortic stiffness, but the putative role of insulin resistance in aortic stiffness over the life course requires further study.

中文翻译：

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从中年到晚年的胰岛素抵抗与晚年的主动脉僵硬度的关联：社区研究中的动脉粥样硬化风险。

背景技术胰岛素抵抗可能导致主动脉硬化，从而导致终末器官损害。我们检查了无糖尿病的老年人的胰岛素抵抗和主动脉僵硬的横断面关联和前瞻性关联。方法我们对第5次就诊（2011-2013年）中的2571名男性和女性进行了分析，对第1次就诊（1987-1989年）至第5次（2011-2013年）中从基线进行重复检查的2350名男女进行了分析。在访问5时，使用线性回归来评估HOMA-IR，TG / HDL-C和TyG的每个标准单位的主动脉僵硬度的差异。使用线性混合效应来评估主动脉僵硬度是否高，而非非高（> 75％百分率）之前，从访视1到访视5的log-HOMA-IR，log-TG / HDL-C和log-TyG的年变化速度更快。结果参与者的平均年龄为75岁，男性为37％（n = 957），非洲裔美国人为17％（n = 433）。在第5次就诊时，较高的HOMA-IR，较高的TG / HDL-C和较高的TyG与较高的主动脉僵硬度相关（每个SD 16 cm / s（95％CI 6，27），每个SD 29 cm / s（95％）每个SD的CI 18、40）和32 cm / s（分别为95％CI 22、42）。从第1次到第5次访问，与非高主动脉僵硬度相比，高主动脉僵硬度之前没有出现从基线到9年的log-HOMA-IR对数年变化加快的趋势（0.030（95％CI 0.024，0.035） vs.0.025（95％CI 0.021，0.028）; p = 0.15）或9年以上（0.011（95％CI 0.007，0.015）vs.0.011（95％CI 0.009，0.013）; p = 0.31）; log-TG / HDL-C从基线到9年（0.019（95％CI 0.015，0.024）与0.024（95％CI 0.022，0.026）; p = 0.06）或9年后（-0.007（95％CI） -0.010，-0.005）vs.-0.009（95％CI-0.010，-0.007）; p = 0.08）; 或从基线到9年的log-TyG（0.002（95％CI 0.002，0.003）vs.0.003（95％CI 0.003，0.003）; p = 0.03）或9年后（0（95％CI 0，0）相对于0（95％CI 0，0）; p = 0.08）。结论在没有糖尿病的老年人中，胰岛素抵抗与主动脉僵硬有关，但是在整个生命过程中胰岛素抵抗在主动脉僵硬中的假定作用尚需进一步研究。