Insulin resistance influences the association of @entity1254 levels with XXXX incidence in two population-based cohorts: the Cooperative Health Research in the Region of Augsburg (KORA) S4/F4 study and the Framingham Offspring Study.

@entity1 @entity1254 @entity164 @entity6
AIMS/HYPOTHESIS: Lower @entity1254 levels are associated with higher risk of incident @entity164 2 @entity6 . Most analyses have been adjusted for confounding factors, but few have taken into account insulin resistance per se. We tested the hypothesis that the association of @entity1254 levels with incident @entity164 2 @entity6 differs between insulin-resistant and insulin-sensitive individuals. METHODS: We studied two prospective cohorts: the Framingham Offspring Study (n   =   2,023) and the Cooperative Health Research in the Region of Augsburg (KORA) S4/F4 study (n   =   887) cohorts. Insulin resistance was estimated by HOMA-insulin resistance (HOMA-IR). We used logistic regression analysis to test the association between @entity1254 and incident @entity164 2 @entity6 overall and in insulin-resistant vs insulin-sensitive individuals (defined by >=  vs <75th percentile of HOMA-IR). RESULTS: At baseline, Framingham's @entity1 were 60        9 years old and 56% were @entity1 ; KORA's @entity1 were 63        5 years old and 49% were @entity1 . @entity164 2 @entity6 incidence was 5.4% over 6.5 years (n   =   109) in Framingham and 10.5% over 8 years (n   =   93) in KORA. Lower @entity1254 levels were associated with @entity164 2 @entity6 incidence in both cohorts. In insulin-resistant individuals, lower @entity1254 levels were associated with higher risk of @entity164 2 @entity6 incidence (OR 1.60 [95% CI 1.10-2.31] per SD decrease in Framingham, p   =   0.01; and OR 2.34 [95% CI 1.16-4.73] in KORA, p   =   0.02); while this was not observed in insulin-sensitive individuals (OR 1.10 [95% CI 0.73-1.67] in Framingham, p   =   0.64; and OR 1.34 [95%CI: 0.88-2.03] in KORA, p   =   0.18). CONCLUSIONS/INTERPRETATION: We conclude that lower @entity1254 levels are associated with higher risk of @entity164 2 @entity6 in insulin-resistant but not in insulin-sensitive individuals. This suggests that some level of insulin resistance is needed to see deleterious effects of low @entity1254 .
