Postabsorptive homeostasis model assessment for insulin resistance is a reliable biomarker for cardiovascular disease mortality and all-cause mortality

Abstract

Aims: This study aimed to investigate associations of postabsorptive homeostasis model assessment for insulin resistance (HOMA-IR) with mortality. Methods: This cohort study included 13,927 US adults, among which 5,552 and 8,375 were examined at the postabsorptive and fasting state, respectively. Mortality outcomes were ascertained by linkage to the National Death Index records. Results: The medians of postabsorptive and fasting HOMA-IR were 2.0 and 2.2, respectively. This cohort was followed up for 271,652 person-years with a mean follow-up of 19.5 years. During the follow-up, 5,235, 1,580, and 493 deaths from all causes, cardiovascular disease (CVD), and diabetes were recorded, respectively. A 1-natural-log-unit increase in postabsorptive HOMA-IR was associated with higher multivariate-adjusted risks for CVD mortality (HR, 1.30; 95% CI, 1.12–1.50) and all-cause mortality (HR, 1.35; 95% CI, 1.25–1.47). Similarly, a 1-natural-log-unit increase in fasting HOMA-IR was associated with higher multivariate-adjusted risks for CVD mortality (HR, 1.30; 95% CI, 1.14–1.48) and all-cause mortality (HR, 1.27; 95% CI, 1.19–1.36). Conclusions: Postabsorptive homeostasis model assessment for insulin resistance is a reliable biomarker for CVD mortality and all-cause mortality.

Keywords

• Insulin resistance
• HOMA
• Non-fasting
• Diabetes
• Mortality