Johanna Kuusisto and colleagues from the University of Eastern Finland conducted a population-based study and found that insulin resistance biomarkers can serve as an independent predictor of the development of the most common heart valve disease—aortic stenosis. The analysis included 10,144 men who participated in the METSIM study and did not have aortic valve disease at baseline. All men underwent comprehensive testing for anthropometric, metabolic, and inflammatory biomarkers. Their association with the subsequent development of aortic stenosis was assessed using principal component analysis and Cox regression analysis. The results were published in the journal Annals of Medicine.
During a median follow-up of 10.8 years, aortic stenosis developed in 116 (1.1 percent) participants at a median age of 62 years. The strongest associations with its risk were demonstrated by fasting, 30-minute, and 120-minute post-glucose plasma insulin and proinsulin levels: hazard ratios (HRs) ranged from 1.38 (95 percent confidence interval 1.12–1.69; p = 2.1 × 10-3) to 1.44 (95 percent confidence interval 1.23–1.68; p = 4.0 × 10-6), as well as the Matsuda insulin sensitivity index (HR 0.68; 95 percent confidence interval 0.56–0.82; p = 6.9 × 10-5) and serum C-peptide concentration (HR 1.47; 95 percent confidence interval 1.22–1.77; p = 5.0 × 10-5). This association remained significant after various adjustments and excluding patients with diabetes. Risk also correlated with age, systolic blood pressure, body mass index, waist-to-hip ratio, height, body fat mass, fat-free mass, and high-sensitivity C-reactive protein levels.
