IGF-1 and Insulin Resistance Are Major Determinants of Common Carotid Artery Thickness in Morbidly Obese Young Patients

Angiology. 2016 Mar;67(3):259-65. doi: 10.1177/0003319715586499. Epub 2015 Jun 17.

Abstract

We assessed the relationship between insulin resistance, serum insulin-like growth factor 1 (IGF-1) levels, and common carotid intima-media thickness (CC-IMT) in morbidly obese young patients. A total of 249 patients (aged 37.9 ± 9.8 years, body mass index [BMI] 45.6 ± 8.3 kg/m(2)) were evaluated (metabolic tests, serum IGF-1 measurements, homeostasis model assessment-insulin resistance [HOMA-IR], and ultrasonographically assessed CC-IMT) in a research program for bariatric surgery candidates. After adjusting for age, gender, BMI, systolic blood pressure, uric acid, antihypertensive and lipid-lowering treatment, metabolic syndrome, and metabolic class, both HOMA-IR and IGF-1 z-score were significantly associated with CC-IMT. These results were confirmed in logistic regression analysis, in which age (β = 1.11, P = .001), gender (β = 3.19, P = .001), HOMA-IR (β = 1.221, P = .005), and IGF-1 z-score (β = 1.734, P = .009) were the only independent determinants of abnormal CC-IMT, presumably modulating the effect of the other risk factors included in the regression. Area under the receiver-operating characteristic curve for the model was 0.841 (confidence interval: 0.776-0.907; P < .001). In conclusion, in morbidly obese young adults, insulin resistance and IGF-1 z-score are significantly associated with CC-IMT, independent of other major cardiovascular risk factors.

Keywords: IGF-1; IMT; atherosclerosis; insulin resistance; morbid obesity.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Factors
  • Area Under Curve
  • Biomarkers / blood
  • Blood Glucose / analysis
  • Body Mass Index
  • Carotid Artery Diseases / blood
  • Carotid Artery Diseases / diagnostic imaging
  • Carotid Artery Diseases / etiology*
  • Carotid Artery, Common / diagnostic imaging*
  • Carotid Intima-Media Thickness
  • Chi-Square Distribution
  • Female
  • Humans
  • Insulin / blood
  • Insulin Resistance*
  • Insulin-Like Growth Factor I / analysis*
  • Linear Models
  • Logistic Models
  • Male
  • Middle Aged
  • Obesity, Morbid / blood
  • Obesity, Morbid / complications*
  • Obesity, Morbid / diagnosis
  • Predictive Value of Tests
  • ROC Curve
  • Risk Assessment
  • Risk Factors

Substances

  • Biomarkers
  • Blood Glucose
  • IGF1 protein, human
  • Insulin
  • Insulin-Like Growth Factor I