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Sex-specific relations between fasting insulin, insulin resistance and incident hypertension: 8.9 years follow-up in a Middle-Eastern population

Journal of Human Hypertension volume 29, pages 260–267 (2015)Cite this article

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Abstract

The purpose of this study was to investigate whether fasting serum insulin levels, homeostasis model assessment of insulin resistance (HOMA-IR) and insulin-to-glucose ratio (IGR) were associated with incident hypertension. In a prospective study, 4093 Iranian participants (1725 men and 2368 women) without hypertension and known diabetes at baseline (1999–2001) were followed for a median of 8.9 years. Regular follow-up examinations were performed at 3-year intervals. Multivariate Cox proportional hazard models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) of incident hypertension adjusting for sex, and in sex-stratified models. During the study, 896 incident cases of hypertension (432 men and 464 women) were identified (total incident rate: 27.5 per 1000 person-years). In the multivariable models, serum insulin level, HOMA-IR and IGR were positively associated with hypertension incidence, adjusting for sex. In the sex-stratified analyses, after adjusting for potential confounders, women in the highest quartile of insulin, HOMA-IR and IG had a significantly higher incidence of hypertension, compared with those in the lowest quartile (HR: 1.7 (95% CI 1.26–2.30); HR: 1.80 (95% CI 1.31–2.40) and HR: 1.67 (95% CI 1.26–2.22), respectively); among men, these relations were also significant, until including waist circumference and body mass index in the models (HR: 1.17 (95% CI 0.85–1.62), HR: 1.25 (95% CI 0.91–1.73) and HR: 1.06 (95% CI 0.77–1.45), respectively). Higher fasting serum insulin levels, HOMA-IR and IGR were associated with incident hypertension among women, whereas these associations were not significant after adjusting for obesity measures in men.

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Acknowledgements

We express our appreciation to the participants of district-13 of Tehran for their enthusiastic support in this study, TLGS labratory staff for their efforts, and would like to acknowledge Ms. Niloofar Shiva for language editing of the manuscript.

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Authors and Affiliations

  1. Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran

    B Arshi, M Tohidi, A Derakhshan, S Asgari & F Hadaegh

  2. Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran

    F Azizi

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  1. B Arshi
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Correspondence to M Tohidi.

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Arshi, B., Tohidi, M., Derakhshan, A. et al. Sex-specific relations between fasting insulin, insulin resistance and incident hypertension: 8.9 years follow-up in a Middle-Eastern population. J Hum Hypertens 29, 260–267 (2015). https://doi.org/10.1038/jhh.2014.70

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