Research Article
Insulin Resistance in Adipose Tissue but Not in Liver Is
Associated with Aortic Valve Calcification
Esteban Jorge-Galarza,
1
Carlos Posadas-Romero,
1
Margarita Torres-Tamayo,
1
Aida X. Medina-Urrutia,
1
Marco A. Rodas-Díaz,
2
Rosalinda Posadas-Sánchez,
1
Gilberto Vargas-Alarcón,
3
María del Carmen González-Salazar,
1
Guillermo C. Cardoso-Saldaña,
1
and Juan G. Juárez-Rojas
1
1
Endocrinology Department, National Institute of Cardiology Ignacio Ch´ avez, Mexico City, Mexico
2
Cardiolology Department, San Juan de Dios General Hospital, Guatemala, Guatemala
3
Molecular Biology Department, National Institute of Cardiology Ignacio Ch´ avez, Mexico City, Mexico
Correspondence should be addressed to Juan G. Ju´ arez-Rojas; gaboyk2@gmail.com
Received 17 October 2016; Accepted 7 December 2016
Academic Editor: Kailash Gulshan
Copyright © 2016 Esteban Jorge-Galarza et al. Tis is an open access article distributed under the Creative Commons Attribution
License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly
cited.
Background. Insulin resistance is involved in the pathogenesis of cardiovascular disease, but its relationship with cardiovascular
calcifcation has yielded conficting results. Te purpose of the present study was to investigate the role of hepatic and adipose
tissue insulin resistance on the presence of coronary artery (CAC > 0) and aortic valve calcifcation (AVC > 0). Methods. In 1201
subjects (52% women, 53.6 ± 9.3 years old) without familiar and personal history of coronary heart disease, CAC and AVC were
assessed by multidetector-computed tomography. Cardiovascular risk factors were documented and lipid profle, infammation
markers, glucose, insulin, and free fatty acids were measured. Hepatic insulin resistance (HOMA-IR) and adipose tissue insulin
resistance (Adipo-IR) indices were calculated. Results. Tere was a signifcant relationship between HOMA-IR and Adipo-IR indices
( = 0.758, < 0.001). Participants in the highest quartiles of HOMA-IR and Adipo-IR indices had a more adverse cardiovascular
profle and higher prevalence of CAC > 0 and AVC > 0. Afer full adjustment, subjects in the highest quartile of Adipo-IR index
had higher odds of AVC > 0 (OR: 2.40; 95% CI: 1.30–4.43), as compared to those in the lowest quartile. Conclusions. Adipo-IR
was independently associated with AVC > 0. Tis suggests that abnormal adipose tissue function favors insulin resistance that may
promote the development and progression of AVC.
1. Introduction
Aortic valve calcifcation (AVC) is defned as calcifed and
thickened aortic leafets that do not impair the blood fow [1].
It is the most common heart valve disorder, increases with
age, and may refect a generalized process of atherosclerosis
[2, 3]. Comparable to AVC, coronary artery calcifcation
(CAC) is a specifc atherosclerosis marker that correlates
with plaque burden and has been a good predictor of future
cardiovascular outcomes in the general population [3]. Some
studies have shown that AVC and CAC share mechanistic
similarities such as infammatory processes, oxidative stress,
dyslipidemia, and endothelial dysfunction [4, 5]. Most of
these risk factors are systemic metabolic insults associated
with the proatherogenic milieu of insulin resistance (IR)
[6, 7]. IR is characterized by decreased insulin-mediated
glucose disposal into peripheral tissues and has been com-
monly determined by the mathematical model described by
Matthews et al. [8]. Using this model (HOMA-IR) some
[9], but not all [10, 11], studies, have shown an association
between IR and CAC. Similarly, although some recent reports
have shown that IR, defned by high HOMA-IR, could
play an important role in the mineralization of the aortic
valve [1, 4, 6], other investigations showed that this associ-
ation was not independent from cardiovascular risk factors
[12].
Hindawi Publishing Corporation
Disease Markers
Volume 2016, Article ID 9085474, 9 pages
http://dx.doi.org/10.1155/2016/9085474