Table 2.
Associations of Gutt insulin sensitivity index and its components with incident ischemic stroke, Cardiovascular Health Study, 1989-2007 (n = 3,442; strokes = 417)*
| Rate per | Unadjusted |
Adjusted 1‡ |
Adjusted 2§ |
|||||
|---|---|---|---|---|---|---|---|---|
| Measure† | Strokes | 1,000 PY | RR | (95% CI) | RR | (95% CI) | RR | (95% CI) |
| Gutt index (mg·L2/mmol·mU·min) | ||||||||
| >77 to 218.2 | 86 | 7.7 | 1.00 | (ref) | 1.00 | (ref) | 1.00 | (ref) |
| >60 to 77 | 90 | 8.3 | 1.08 | (0.81, 1.46) | 1.10 | (0.81, 1.48) | 1.03 | (0.76, 1.39) |
| >47 to 60 | 112 | 10.6 | 1.38 | (1.04, 1.83) | 1.37 | (1.03, 1.83) | 1.24 | (0.93, 1.65) |
| 25.8 to 47 | 129 | 13.0 | 1.71 | (1.30, 2.24) | 1.64 | (1.24, 2.16) | 1.39 | (1.05, 1.86) |
| p for trend | <0.001 | <0.001 | 0.02 | |||||
| Fasting glucose (mmol/L)# | ||||||||
| 3.2 to 5.2 | 111 | 9.2 | 1.00 | (ref) | 1.00 | (ref) | 1.00 | (ref) |
| >5.2 to 5.4 | 99 | 10.0 | 1.09 | (0.83, 1.43) | 1.07 | (0.82, 1.41) | 1.07 | (0.81, 1.40) |
| >5.4 to 5.8 | 111 | 10.1 | 1.10 | (0.84, 1.43) | 1.02 | (0.78, 1.33) | 0.94 | (0.72, 1.23) |
| >5.8 to 6.9 | 96 | 10.2 | 1.12 | (0.85, 1.47) | 1.07 | (0.81, 1.41) | 0.94 | (0.71, 1.25) |
| p for trend | 0.43 | 0.73 | 0.51 | |||||
| Fasting insulin (pmol/L)# | ||||||||
| 20.8 to 62.5 | 121 | 9.9 | 1.00 | (ref) | 1.00 | (ref) | 1.00 | (ref) |
| >62.5 to 83.3 | 106 | 9.2 | 0.92 | (0.71, 1.19) | 0.92 | (0.71, 1.20) | 0.87 | (0.66, 1.13) |
| >83.3 to 111.1 | 97 | 10.0 | 1.00 | (0.77, 1.31) | 1.04 | (0.79, 1.37) | 0.93 | (0.71, 1.23) |
| >111.1 to 722.3 | 93 | 10.3 | 1.04 | (0.80, 1.37) | 1.10 | (0.84, 1.46) | 0.93 | (0.69, 1.25) |
| p for trend | 0.61 | 0.34 | 0.83 | |||||
| 2-hour glucose (mmol/L)# | ||||||||
| 2.1 to 5.8 | 84 | 7.4 | 1.00 | (ref) | 1.00 | (ref) | 1.00 | (ref) |
| >5.8 to 7.0 | 94 | 8.7 | 1.19 | (0.89, 1.60) | 1.23 | (0.91, 1.65) | 1.13 | (0.84, 1.52) |
| >7.0 to 8.4 | 100 | 9.4 | 1.28 | (0.96, 1.71) | 1.32 | (0.98, 1.77) | 1.18 | (0.87, 1.59) |
| >8.4 to 11.0 | 139 | 14.4 | 1.98 | (1.51, 2.60) | 1.84 | (1.39, 2.42) | 1.57 | (1.18, 2.09) |
| p for trend | <0.001 | <0.001 | 0.001 | |||||
| 2-hour insulin (pmol/L)# | ||||||||
| 34.7 to 270.9 | 87 | 7.6 | 1.00 | (ref) | 1.00 | (ref) | 1.00 | (ref) |
| >270.9 to 437.5 | 96 | 9.2 | 1.22 | (0.91, 1.63) | 1.24 | (0.93, 1.67) | 1.17 | (0.87, 1.58) |
| >437.5 to 687.6 | 122 | 11.9 | 1.57 | (1.19, 2.07) | 1.57 | (1.19, 2.07) | 1.41 | (1.07, 1.87) |
| >687.6 to 2,778.0 | 112 | 10.9 | 1.44 | (1.09, 1.91) | 1.43 | (1.08, 1.90) | 1.25 | (0.93, 1.67) |
| p for trend | 0.01 | 0.02 | 0.18 | |||||
| Body weight (kg) | ||||||||
| 34.8 to 60 | 102 | 10.3 | 1.00 | (ref) | 1.00 | (ref) | 1.00 | (ref) |
| >60 to 70 | 116 | 10.3 | 0.99 | (0.76, 1.29) | 0.99 | (0.75, 1.31) | 0.95 | (0.72, 1.26) |
| >70 to 80 | 95 | 8.5 | 0.81 | (0.62, 1.08) | 0.84 | (0.62, 1.15) | 0.78 | (0.57, 1.07) |
| >80 to 146.5 | 104 | 10.3 | 1.00 | (0.76, 1.31) | 1.07 | (0.77, 1.48) | 0.94 | (0.67, 1.31) |
| p for trend | 0.68 | 0.85 | 0.55 | |||||
Abbreviations: PY, person years; RR, relative risk; CI, confidence interval.
For each measure, the reference category was the least insulin resistant quartile (highest quartile for Gutt index; lowest quartilefor each component).
Adjusted for age, sex, race, estimated glomerular filtration rate, coronary heart disease, congestive heart failure, atrial fibrillation, and peripheral arterial disease.
Adjusted for all of the above plus systolic blood pressure, antihypertensive medication use, triglyceride, HDL cholesterol, and LDL cholesterol.
Conversions: insulin, μU/mL = (pmol/L)/6.945; glucose, mg/dL = (mmol/L)/0.0555.