Comparison of carotid intima media thickness and high sensitive c-reactive protein with hemostasis model assessment for insulin resistance in prediabetes and normoglycemic patients: A case-control study
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Abstract
Background: Hyperglycaemia and insulin resistance (IR) are two significant risk factors for atherosclerotic cardiovascular disease (ASCVD). While the relationship between diabetes and atherosclerosis has been extensively studied and well established, data on prediabetes are scarce. The carotid artery intima-media thickness (CIMT) and high-sensitivity C-reactive protein (hs-CRP) are both well-established markers of subclinical atherosclerosis.
Objectives: The purpose of this study was to compare homeostasis model assessment-IR (HOMA-IR) levels in prediabetic and normoglycemic subjects, as well as to assess the relationship between HOMA-IR with hs-CRP and CIMT levels between these two groups.
Materials and methods: This case-control study enrolled 52 prediabetic patients and 52 normoglycemic controls. Glycaemic profile and hs-CRP were determined and HOMA-IR were calculated using fasting glucose and insulin values and bilateral CIMT measurements were taken. SPSS (ver_24.0) was used for analysis and based on the distribution of data analysis was performed.
Results: In both cases and controls, the mean serum fasting insulin level was 13.92±4.27 mIU/mL and 5.21±2.46 mIU/mL, respectively (p<0.001). The mean HOMA-IR values were 3.70±1.1 and 1.21±0.58, respectively (p<0.001). The mean CIMT was significantly greater in prediabetics (0.62±0.07mm) than in controls (0.45±0.08 mm) (p<0.001). Additionally, prediabetics had significantly higher serum-levels (5.70±3.35 mg/L) tan controls (1.88±1.35 mg/L) (p<0.001). A positive correlation of HOMA-IR existed between mean CIMT (p<0.001; r=0.631), and hs-CRP (p<0.001; r=0.498).
Conclusion: Prediabetic adults had higher CIMT and hs-CRP than normoglycemic controls, and HOMA-IR correlated positively with both, indicating greater subclinical atherosclerosis burden. These associations suggest IR may aid ASCVD risk stratification in prediabetes, though longitudinal studies are needed to confirm prognostic value.
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