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Abstract：
There is a relative scarcity of large-scale population studies investigating the relationship between the insulin resistance index of homeostasis model assessment (HOMA-IR) and vascular damage. Therefore, we assessed the association between HOMA-IR and vascular damage in adults aged 18 years and older in China. A total of 17,985 research subjects were included. Vascular damage markers and relevant laboratory tests were measured. HOMA-IR was calculated as (fasting insulin * fasting blood glucose)/22.5. Vascular damage included arteriosclerosis (ba-PWV > 1800 cm/s), peripheral artery disease (ABI < 0.9), and microalbuminuria (UACR > 30 mg/g). The relationship between HOMA-IR and vascular damage was analyzed using the RCS. The restricted cubic spline (RCS) analysis suggested that HOMA-IR was nonlinearly associated with arteriosclerosis (P for no-liner < 0.01), peripheral artery disease (P for no-liner < 0.01), and microalbuminuria (P for no-liner < 0.01). Further segmented regression analyses revealed that in study subjects with HOMA-IR < 5, we found that HOMA-IR was associated with an increased OR for arteriosclerosis (OR: 1.36, 95% CI (1.28, 1.45), P < 0.01), peripheral artery disease (OR: 1.33, 95% CI (1.10, 1.60), P < 0.01) and microalbuminuria (OR: 1.59, 95% CI (1.49, 1.70), P < 0.01). HOMA-IR is an independent risk factor for vascular damage, both macrovascular and microvascular. The phenomenon of saturation of HOMA-IR with vascular damage needs further investigation.
摘要：
研究稳态模型评估的胰岛素抵抗指数（HOMA-IR）与血管损伤之间关系的大规模人群研究相对缺乏。因此,我们评估了中国18岁及以上成人中HOMA-IR与血管损害之间的关系.总共包括17,985个研究对象。测量血管损伤标志物和相关实验室测试。HOMA-IR计算为(空腹胰岛素*空腹血糖)/22.5。血管损害包括动脉硬化（ba-PWV>1800cm/s），外周动脉疾病（ABI<0.9），和微量白蛋白尿（UACR>30mg/g）。使用RCS分析HOMA-IR与血管损伤之间的关系。受限三次样条(RCS)分析提示HOMA-IR与动脉硬化呈非线性相关(P表示非线性<0.01),外周动脉疾病（无衬垫P<0.01），和微量白蛋白尿（P<0.01）。进一步的分段回归分析显示，在HOMA-IR<5的研究对象中，我们发现HOMA-IR与动脉硬化的OR增加有关（OR：1.36，95％CI（1.28，1.45），P<0.01),外周动脉疾病（OR：1.33，95%CI（1.10，1.60），P<0.01）和微量白蛋白尿（OR：1.59，95％CI（1.49，1.70），P<0.01)。HOMA-IR是血管损伤的独立危险因素,大血管和微血管。HOMA-IR饱和与血管损伤的现象需要进一步研究。
