Diabetes, insulin resistance strongly associated with premature coronary heart disease among women

Diabetes and insulin resistance are “major determinants” of premature coronary heart disease (CHD) among women, according to new findings published in JAMA Cardiology. Researchers also identified other risk factors associated with premature CHD, noting that many of them can be modified through “lifestyle or preventive interventions.”

The study’s authors explored data from more than 28,000 women who participated in the Women’s Health Study from April 1993 to January 1996. The median follow-up period for participants was 21.4 years.

The research team focused on approximately 50 different biomarkers, tracking how each one appeared to impact a patient’s chances of developing premature CHD. For women younger than 55 years old, lipoprotein insulin resistance (LPIR) had a much stronger association with CHD than more well-known biomarkers such as LDL cholesterol or hemoglobin A1c. Other risk factors associated with premature CHD among these patients included hypertension, obesity and smoking.

“Prevention is better than cure, and many risk factors for heart disease are preventable,” co-first author Sagar Dugani, MD, PhD, an internal medicine practitioner at Mayo Clinic in Rochester, Minnesota, said in a prepared statement. “This study shows the impact that lifestyle has on heart health in women of all ages, and younger women in particular.”

“Diabetes is mostly preventable, but it's a systems-wide problem, and we urgently need further research into new strategies to address it,” added corresponding author Samia Mora, MD, of the Brigham’s Center for Lipid Metabolomics at Brigham and Women’s Hospital. “These could be innovative lifestyle-based strategies, like community efforts, greater public health efforts, ways to medically target metabolic pathways, or new surgical approaches.”

The study is available here.