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Analysis of institutional authors

García-Alvarez AAuthorMendieta GAuthor
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Article

Early insulin resistance in normoglycemic low-risk individuals is associated with subclinical atherosclerosis

Publicated to:Cardiovascular Diabetology. 22 (1): 350- - 2023-12-19 22(1), DOI: 10.1186/s12933-023-02090-1

Authors: Iglesies-Grau, Josep; Garcia-Alvarez, Ana; Oliva, Belen; Mendieta, Guiomar; Garcia-Lunar, Ines; Fuster, Jose J; Devesa, Ana; Perez-Herreras, Cristina; Fernandez-Ortiz, Antonio; Brugada, Ramon; Ibanez, Borja; Fernandez-Jimenez, Rodrigo; Fuster, Valentin

Affiliations

Banco Santander, Med Serv - Author
Cardiology Departement, Institut Clinic Cardiovascular, Hospital Clínic de Barcelona, Barcelona, Spain. - Author
Cardiology Department, University Hospital La Moraleja, Madrid, Spain. - Author
Centro Nacional de Investigaciones Cardiovasculares (CNIC), Calle Melchor Fernández Almagro, 3, Madrid, 28029, Spain. - Author
Centro Nacional de Investigaciones Cardiovasculares (CNIC), Calle Melchor Fernández Almagro, 3, Madrid, 28029, Spain. rfernandez@cnic.es. - Author
Centro Nacional de Investigaciones Cardiovasculares (CNIC), Calle Melchor Fernández Almagro, 3, Madrid, 28029, Spain. vfuster@cnic.es. - Author
CIBER de Enfermedades CardioVasculares (CIBERCV), Madrid, Spain. - Author
CIBER de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain. rfernandez@cnic.es. - Author
CIBER Enfermedades Cardiovasc CIBERCV - Author
Ctr Nacl Invest Cardiovasc, Calle Melchor Fernandez Almagro 3 - Author
Department of Cardiology, Hospital Universitari Dr. Josep Trueta, Girona, Spain. - Author
Hosp Univ Clin San Carlos - Author
Hospital Universitario Clínico San Carlos, Madrid, Spain. - Author
Hospital Universitario Clínico San Carlos, Madrid, Spain. rfernandez@cnic.es. - Author
Icahn Sch Med Mt Sinai ISMMS, Zena & Michael A Wiener Cardiovasc Inst - Author
IIS Fdn Jimenez Diaz Univ Hosp - Author
IIS-Fundación Jiménez Díaz University Hospital, Madrid, Spain. - Author
Inst Invest Biomed August Pi & Sunyer IDIBAPS - Author
Inst Invest Biomed Girona IDIBGI - Author
Institut d'Investigació Biomédica de Girona (IdIBGi), Girona, Spain. - Author
Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain. - Author
Medical Services, Banco Santander, Madrid, Spain. - Author
Research Center and Centre ÉPIC, Montreal Heart Institute, Montréal, Canada. - Author
The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai (ISMMS), New York, NY, USA. - Author
The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai (ISMMS), New York, NY, USA. vfuster@cnic.es. - Author
Univ Girona - Author
Univ Hosp Moraleja, Cardiol Dept - Author
Universitat de Girona, Girona, Spain. - Author
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Abstract

Elevated glycated hemoglobin (HbA1c) is associated with a higher burden of subclinical atherosclerosis (SA). However, the association with SA of earlier insulin resistance markers is poorly understood. The study assessed the association between the homeostatic model assessment of insulin resistance index (HOMA-IR) and SA in addition to the effect of cardiovascular risk factors (CVRFs) in individuals with normal HbA1c.A cohort of 3,741 middle-aged individuals from the Progression of Early Subclinical Atherosclerosis (PESA) study with basal HbA1c < 6.0% (< 42 mmol/mol) and no known CV disease underwent extensive imaging (multiterritorial vascular ultrasound and coronary artery calcium score, CACS) to assess the presence, burden, and extent of SA.Individuals with higher HOMA-IR values had higher rates of CVRFs. HOMA-IR showed a direct association with the multiterritorial extent of SA and CACS (p < 0.001) and with global plaque volume measured by 3-dimensional vascular ultrasound (p < 0.001). After adjusting for key CVRFs and HbA1c, HOMA-IR values ≥ 3 were associated with both the multiterritorial extent of SA (odds ratio 1.41; 95%CI: 1.01 to 1.95, p = 0.041) and CACS > 0 (odds ratio 1.74; 95%CI: 1.20 to 2.54, p = 0.004), as compared with the HOMA-IR < 2 (the reference HOMA-IR category). In a stratified analysis, this association remained significant in individuals with a low-to-moderate SCORE2 risk estimate (75.6% of the cohort) but not in high-risk individuals.The use of HOMA-IR identified low-risk individuals with a higher burden of SA, after adjusting for the effects of key traditional CVRFs and HbA1c. HOMA-IR is a simple measure that could facilitate earlier implementation of primary CV prevention strategies in clinical practice.© 2023. The Author(s).

Keywords
AdultAgeAgedArticleAtherosclerosisAtherosclerotic plaqueBody massC reactive proteinCardiovascular diseaseCardiovascular riskCholesterolClinical assessment toolClinical practiceClinical protocolClinical studyCohort analysisControlled studyCoronary artery calcium scoreCross-sectional studyDiagnostic imagingDisease associationDisease burdenDisease classificationDisease durationDyslipidemiaErythrocyte sedimentation rateFamily historyFemaleFerritinFibrinogenFramingham risk scoreGenderGlucoseGlucose blood levelGlycated hemoglobinHemoglobin a1cHigh density lipoprotein cholesterolHigh risk patientHoma indexHumanHumansHypertensionImage analysisImagingInsulinInsulin resistanceLow density lipoprotein cholesterolLow risk patientMajor clinical studyMaleMathematical analysisMetabolic syndrome xMiddle agedMultivariate analysisOdds ratioPlaque, atheroscleroticPrimary disease preventionProphylaxisRegicor risk scoreRegression analysisRisk assessmentRisk factorRisk factorsScore2Sedentary lifestyleSensitivity analysisSmokingSubclinical atherosclerosisSystolic blood pressureThree dimensional vascular ultrasoundTriacylglycerolWaist circumference

Quality index

Bibliometric impact. Analysis of the contribution and dissemination channel

The work has been published in the journal Cardiovascular Diabetology due to its progression and the good impact it has achieved in recent years, according to the agency WoS (JCR), it has become a reference in its field. In the year of publication of the work, 2023, it was in position 11/186, thus managing to position itself as a Q1 (Primer Cuartil), in the category Endocrinology & Metabolism. Notably, the journal is positioned above the 90th percentile.

From a relative perspective, and based on the normalized impact indicator calculated from World Citations from Scopus Elsevier, it yields a value for the Field-Weighted Citation Impact from the Scopus agency: 1.15, which indicates that, compared to works in the same discipline and in the same year of publication, it ranks as a work cited above average. (source consulted: ESI Nov 14, 2024)

This information is reinforced by other indicators of the same type, which, although dynamic over time and dependent on the set of average global citations at the time of their calculation, consistently position the work at some point among the top 50% most cited in its field:

  • Field Citation Ratio (FCR) from Dimensions: 8.11 (source consulted: Dimensions May 2025)

Specifically, and according to different indexing agencies, this work has accumulated citations as of 2025-05-17, the following number of citations:

  • WoS: 3
  • Scopus: 6
  • Europe PMC: 3
  • OpenCitations: 5
Impact and social visibility

From the perspective of influence or social adoption, and based on metrics associated with mentions and interactions provided by agencies specializing in calculating the so-called "Alternative or Social Metrics," we can highlight as of 2025-05-17:

  • The use, from an academic perspective evidenced by the Altmetric agency indicator referring to aggregations made by the personal bibliographic manager Mendeley, gives us a total of: 23.
  • The use of this contribution in bookmarks, code forks, additions to favorite lists for recurrent reading, as well as general views, indicates that someone is using the publication as a basis for their current work. This may be a notable indicator of future more formal and academic citations. This claim is supported by the result of the "Capture" indicator, which yields a total of: 22 (PlumX).

With a more dissemination-oriented intent and targeting more general audiences, we can observe other more global scores such as:

  • The Total Score from Altmetric: 79.1.
  • The number of mentions on the social network X (formerly Twitter): 130 (Altmetric).

It is essential to present evidence supporting full alignment with institutional principles and guidelines on Open Science and the Conservation and Dissemination of Intellectual Heritage. A clear example of this is:

  • The work has been submitted to a journal whose editorial policy allows open Open Access publication.
Leadership analysis of institutional authors

This work has been carried out with international collaboration, specifically with researchers from: Canada; United States of America.