Native8aworks.com – In initially healthy women, lipoprotein insulin resistance (LPIR) score is strongly associated with incident diabetes, independent of risk factors that include body mass index, hemoglobin A1c levels and lipids, according to research presented Tuesday at Scientific Sessions.
The study also indicated that the LPIR score had a stronger association than BMI with diabetes, said Paulo Henrique Nascimento Harada, MD, MPH, a research fellow in the divisions of preventive and cardiovascular medicine at Brigham and Women’s Hospital in Boston.
The LPIR score is a composite of six lipoprotein parameters measured by nuclear magnetic resonance spectroscopy that reflects the lipoprotein derangements of insulin resistance, which may be apparent years before the onset of overt hyperglycemia. The parameters are: very-low-density lipoprotein (VLDL), high-density (HDL) and low-density (LDL) lipoprotein particles of average size, and concentrations of large VLDL, large HDL and small LDL subclasses.
Harada said this more-sensitive biomarker might allow for earlier detection of type 2 diabetes risk.
“Type 2 diabetes is a disease with very indolent and silent progression that is associated with comorbidities even before its diagnosis,” Harada said. “Therefore, if we accurately identify individuals at risk earlier along the path to disease, we may intervene for at-risk populations in a timely way.”
The findings came from 25,925 participants in the Women’s Health Study.
In the study’s preliminary results, the researchers reported that individuals with an LPIR score greater than 67 had twice the risk of diabetes compared to those with an LPIR score less than 30, and the risk increased linearly along the LPIR spectrum. LPIR scores range from zero, the most insulin sensitive, to 100, the most insulin resistant.
“It is quite impressive, the magnitude of LPIR association with diabetes in this relatively healthy population,” Harada said. “Moreover, LPIR association with diabetes was larger than other traditional markers like triglycerides, HDL-c, BMI and high-sensitivity C-reactive protein.”
Comparing LPIR Q4 (>67) versus Q1 (<30), the unadjusted hazard ratio (HR) was 11.08, which remained significant but attenuated to 2.22 (1.72 to 2.85) in the fully adjusted model that included BMI, lipids and HbA1c. In comparing fully adjusted standardized HRs for incident diabetes, the HR per standard deviation of LPIR was 1.42 (1.31 to 1.54), greater than the components of LPIR and other markers of diabetes. It is significant that LPIR was associated with diabetes risk by a high magnitude in a population with a very good metabolic profile at baseline, and therefore at low risk of diabetes, Harada said. The study’s results align with recently published results from the Multi-Ethnic Study of Atherosclerosis (MESA), Harada said. However, he noted, the MESA study’s population is six years older, and had higher BMI and shorter duration of follow-up.
