Author, as appears in the article.: Cano, Albert; Llaurado, Gemma; Albert, Lara; Mazarico, Isabel; Astiarraga, Brenno; Gonzalez-Sastre, Montserrat; Martinez, Laia; Fernandez-Veledo, Sonia; Simo, Rafael; Vendrell, Joan; Gonzalez-Clemente, Jose-Miguel;

Department: Medicina i Cirurgia Ciències Mèdiques Bàsiques

URV's Author/s: Domínguez Porfirio, Brenno / Fernandez Veledo, Sonia / Vendrell Ortega, Juan José

Keywords: Type 1 diabetes Steno type 1 risk engine Sensitivity Prediction Plasma Metabolic syndrome Mellitus Insulin resistance Glucose Excess mortality Estimated insulin sensitivity Disease Coronary-artery calcification Complications Cardiovascular risk steno type 1 risk engine insulin resistance estimated insulin sensitivity cardiovascular risk

Abstract: Background: We sought to assess the potential of insulin resistance (IR) for estimating cardiovascular disease (CVD) risk in adults with type 1 diabetes (T1DM) according to the scores of the Steno Type 1 Risk Engine (ST1RE). Methods: A total of 179 adults with T1DM (50.8% men, age 41.2 +/- 13.1 years, duration of T1DM 16 (12-23) years) without established CVD were evaluated. IR was assessed by the estimation of insulin sensitivity (eIS) using two validated prediction equations: the estimated insulin sensitivity developed from the Pittsburgh Epidemiology of Diabetes Complications Study (eIS-EDC) and the estimated insulin sensitivity developed from Coronary Artery Calcification in T1DM Study (eIS-CACTI) ST1RE was used to estimate 10-year CVD risk and to classify subjects into three groups according to their risk: low (n= 105), moderate (10-20%;n= 53), and high (>= 20%;n= 21). Results: Both eIS-EDC and eIS-CACTI correlated negatively with ST1RE scores (eIS-EDC: r = -0.636,p< 0.001; eIS-CACTI: r = -0.291,p< 0.001). The C-statistic for predicting moderate/high risk and high risk was 0.816 (95% confidence interval (CI): 0.754-0.878) and 0.843 (95% CI: 0.772-0.913), respectively, for the eIS-EDC equation, and was 0.686 (95% CI: 0.609-0.763) and 0.646 (95% CI: 0.513-0.778), respectively, for the eIS-CACTI equation. The eIS-EDC equation had a significantly higher C-statistic both for moderate-/high-risk (p= 0.001) and high-risk (p= 0.007) subjects. Two cut-off points of eIS-EDC were identified for detecting moderate/high risk (8.52 mg center dot kg(-1)center dot min(-1); sensitivity 74% and specificity 76%) and high risk (8.08 mg center dot kg(-1)center dot min(-1); sensitivity 65% and specificity 95%) with potential applicability in clinical practice. Conclusions: eIS negatively correlates with the score of CVD risk in the ST1RE. Two cut-off points of eIS are reported with potential utility in clinical practice for detecting adults with T1DM with the highest CVD risk.

Thematic Areas: Medicine, general & internal Medicine (miscellaneous) Medicine (all)

licence for use: https://creativecommons.org/licenses/by/3.0/es/

Author's mail: brenno.dominguez@urv.cat sonia.fernandez@urv.cat juanjose.vendrell@urv.cat

Author identifier: 0000-0003-2216-8974 0000-0003-2906-3788 0000-0002-6994-6115

Record's date: 2023-03-18

Papper version: info:eu-repo/semantics/publishedVersion

Link to the original source: https://www.mdpi.com/2077-0383/9/7/2192

Licence document URL: http://repositori.urv.cat/ca/proteccio-de-dades/

Papper original source: Journal Of Clinical Medicine. 9 (7): 1-12

APA: Cano, Albert; Llaurado, Gemma; Albert, Lara; Mazarico, Isabel; Astiarraga, Brenno; Gonzalez-Sastre, Montserrat; Martinez, Laia; Fernandez-Veledo, Soni (2020). Utility of Insulin Resistance in Estimating Cardiovascular Risk in Subjects with Type 1 Diabetes According to the Scores of the Steno Type 1 Risk Engine. Journal Of Clinical Medicine, 9(7), 1-12. DOI: 10.3390/jcm9072192

Article's DOI: 10.3390/jcm9072192

Entity: Universitat Rovira i Virgili

Journal publication year: 2020

Publication Type: Journal Publications