A new biomarker of insulin resistance is associated with a 600% increased risk of early coronary disease.

While heart disease-related deaths have decreased in older people, studies show that mortality in younger patients remains stagnant or slightly increased. To understand what factors put young people at higher risk of premature coronary heart disease (CHD), researchers from Women’s Hospital and Brigham and Mayo Clinic analyzed more than 50 risk factors in 28,024 women participating in the decades-long Women’s Health Study. Notably, women under 55 years of age with type 2 diabetes have a 10-fold increased risk of developing CHD over the next two decades, with lipoprotein insulin resistance (LPIR) shown to be a prognostic biomarker. guess, strong. The results were published in JAMA Cardiology.

“Unfortunately, we’re going to see younger and younger people having heart attacks,” says journal contact author Samia Mora, MD, MHS, of the Brigham Center for Lipid Metabolism in the Department of Preventive Medicine and an associate Professor at Harvard Medical School said. “When a younger individual suffers from a cardiovascular event, it affects their later quality of life, their productivity and their contribution to society.”

Sagar Dugani, MD, PhD, a hospital internist at the Mayo Clinic in Rochester, MN. “Prevention is better than cure, and many risk factors for heart disease are preventable,” said Dr. Dugani, co-first author of the study. This study demonstrates the impact of lifestyle on cardiovascular health in women of all ages and young women in particular.”

The researchers analyzed about 50 biomarkers associated with heart health. Commonly used metrics such as low-density lipoprotein (LDL) cholesterol (or “bad” cholesterol) and HbA1C (a measure of blood sugar) have less association with the onset of CHD in women younger than 55 years of age compared with the onset of CHD. with LPIR, a newer metric for insulin resistance. LPIR uses a weighted combination of six lipoprotein measures and is analyzed through specialized laboratory testing. While LDL cholesterol was only associated with a 40% increased risk of onset of CHD in women younger than 55 years of age, LPIR has been shown to increase sixfold (600%).

“In healthy women, insulin resistance, type 2 diabetes and its sister diagnosis, metabolic syndrome, are the major causes of early coronary diseases,” says Mora. “Women under 55 who are obese are four times more likely to develop coronary heart disease, as are women in that age group who smoke or have high blood pressure. Physical inactivity and family history are both part of the problem.”

The researchers acknowledge that the study has limited generalizability — beyond focusing on women, who have been shown to have worse outcomes after heart events earlier than men. , the study participants were over 95% white. According to Mora, the findings could be even more dramatic in ethnic and racial groups with higher rates of metabolic syndrome, insulin resistance and diabetes, among other risk factors.

“Diabetes is mostly preventable, but it is a global problem and we urgently need more research on new strategies to tackle it,” says Mora. “These could be lifestyle-based innovation strategies, like community efforts, larger public health efforts, how to make metabolic interventions or new surgical approaches.”

With the prevalence of diabetes and its associated risk factors significantly increasing and affecting more women than men, the researchers underline the urgency of developing measures. effective intervention.

“We need new strategies to improve outcomes in these younger people and address diabetes risk, because we have only just seen the beginning of this pandemic,” added Mora.

Information sources:

Materials provided by Brigham and Women’s Hospital. Note: Content may have been modified in presentation and length.

References:

1. Association of Lipid, Inflammatory, and Metabolic Biomarkers With Age at Onset for Incident Coronary Heart Disease in Women. JAMA Cardiology, 2021

Sagar B. Dugani, M. Vinayaga Moorthy, Chunying Li, Olga V. Demler, Alawi A. Alsheikh-Ali, Paul M Ridker, Robert J. Glynn, Samia Mora.

DOI: https://jamanetwork.com/journals/jamacardiology/article-abstract/2775559

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Source: ScienceDaily

Link: https://www.sciencedaily.com/releases/2021/01/210120114835.htm

Author: Roxie Duong