| OBJECTIVES: Insulin resistance is believed to be the defect underlying the occurrence of hypertension, dyslipidaemia and diabetes. The evidence for this hypothesis is based on the association of fasting insulin, as a proxy for insulin resistance, with the risk of cardiovascular disease. Thus it is not known whether insulin resistance of hyperinsulinemia per se is driving the association. Because the gold standard for measuring insulin resistance, the euglycaemic hyperinsulinaemic clamp technique, is time-consuming and invasive, no previous prospective study has assessed the relationship between insulin resistance and cardiovascular disease. Therefore, the objectives are: 1) to establish whether insulin resistance predicts the future development of cardiovascular risk markers and cardiovascular disease, 2) to determine genetic and environmental contributions to insulin resistance, and 3) to develop a new method to identify insulin-resistant subjects in clinical practice. METHODS: A prospective, observational, multi-centre cohort study measuring insulin resistance and secretion in a cohort of 1,500 subjects, recruited in 20 European study centres. As the principal aim is to test the hypothesis that insulin resistance precedes the development of cardiovascular disease, the carotid intima-media thickness will be measured at baseline and after 3 years of follow up. The study will start January 2003 in Hoorn, and 75 subjects will be included. |
