d6c6cf2b3a8cf5be7da738851266e7ab Jouclimed_a2020v9n7p2192.pdf c3100f799e42ecddedf5dbd0b37b8d321fc1b160 Jouclimed_a2020v9n7p2192.pdf 310fb493ede0827fce94359733dbb04d44a4735b468751e15d060ce0a7eba4b2 Jouclimed_a2020v9n7p2192.pdf Title: 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 Subject: 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 (<10%; 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 mgkg-1min-1; sensitivity 74% and specificity 76%) and high risk (8.08 mgkg-1min-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. Keywords: type 1 diabetes; cardiovascular risk; steno type 1 risk engine; estimated insulin sensitivity; insulin resistance Author: Albert Cano, Gemma Llauradó, Lara Albert, Isabel Mazarico, Brenno Astiarraga, Montserrat González-Sastre, Laia Martínez, Sonia Fernández-Veledo, Rafael Simó, Joan Vendrell and José-Miguel González-Clemente Creator: LaTeX with hyperref package Producer: pdfTeX-1.40.18 CreationDate: Sat Jul 11 10:38:55 2020 CEST ModDate: Sat Jul 11 10:38:55 2020 CEST Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 12 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 1101786 bytes Optimized: no PDF version: 1.5 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- MMELVY+URWPalladioL-Ital Type 1 Custom yes yes no 74 0 WPGGRT+URWPalladioL-Bold Type 1 Custom yes yes no 75 0 QTLELQ+Pxbsy Type 1 Builtin yes yes no 76 0 JYPLJJ+VnURWPalladioL-Bold 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yes yes no 254 0 FLLMJJ+PalatinoLinotype CID TrueType Identity-H yes yes yes 255 0 FLLMJK+PalatinoLinotype TrueType WinAnsi yes yes no 256 0 FLLMJM+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 257 0 FLLNEJ+TimesNewRoman CID TrueType Identity-H yes yes yes 258 0 VSHNAE+Rpcxr Type 1 Builtin yes yes no 371 0 Jhove (Rel. 1.22.1, 2019-04-17) Date: 2020-11-17 06:07:44 CET RepresentationInformation: Jouclimed_a2020v9n7p2192.pdf ReportingModule: PDF-hul, Rel. 1.12.1 (2019-04-17) LastModified: 2020-10-21 12:25:18 CEST Size: 1101786 Format: PDF Version: 1.5 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 0 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: ViewerPreferences: HideToolbar: false HideMenubar: false HideWindowUI: false FitWindow: true CenterWindow: false DisplayDocTitle: false NonFullScreenPageMode: UseNone Direction: L2R ViewArea: CropBox ViewClip: CropBox PrintArea: CropBox PageClip: CropBox PageLayout: SinglePage 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