Is elevated fasting insulin or insulin resistance (HOMA-IR) associated with an increased risk of cardiovascular or all-cause mortality in non-diabetic adults?
Fasting Insulin / HOMA-IR Kit, a meta-analysis (Biosci Rep 2017, PMID 28811358) — the pooled adjusted RR for all-cause mortality was 1.13 (95% CI: 1.00-1.27) for fasting insulin and 1.34 (95% CI: 1.11-1.62) for HOMA-IR. The association of fasting insulin and HOMA-IR with cardiovascular mortality may be unreliable due to the small number of articles included for these specific associations.
Source: Biosci Rep 2017, PMID 28811358 ↗ · Research map · How Magellan grades evidence · evidence confidence: high
Biosci Rep · 2017 · PMID 28811358 · DOI 10.1042/BSR20170947
High insulin resistance (HOMA-IR) is linked to increased risk of death from any cause and cardiovascular disease in non-diabetic adults, but high fasting insulin alone is not.
The question
Is elevated fasting insulin or insulin resistance (HOMA-IR) associated with an increased risk of cardiovascular or all-cause mortality in non-diabetic adults?
What they tested
The study aimed to evaluate the association of elevated fasting insulin levels or insulin resistance (HOMA-IR) with cardiovascular or all-cause mortality in non-diabetic adults, given conflicting results from previous studies.
How they did it
This meta-analysis searched PubMed and Embase databases for prospective observational studies published until November 2016. Studies investigating the association of elevated fasting insulin or HOMA-IR with cardiovascular or all-cause mortality in non-diabetic adults were included. Risk ratios (RR) with 95% confidence intervals (CIs) were pooled for the highest compared with the lowest categories of fasting insulin or HOMA-IR.
What they found
Seven articles involving 26,976 non-diabetic adults were included. The pooled adjusted RR for all-cause mortality was 1.13 (95% CI: 1.00-1.27) for fasting insulin and 1.34 (95% CI: 1.11-1.62) for HOMA-IR. For cardiovascular mortality, the pooled adjusted RR was 2.11 (95% CI: 1.01-4.41) for HOMA-IR (from two studies) and 1.40 (95% CI: 0.49-3.96) for fasting insulin (from one study).
| Fasting Insulin (All-cause mortality) | 1.13 | |
|---|---|---|
| HOMA-IR (All-cause mortality) | 1.34 | |
| HOMA-IR (Cardiovascular mortality) | 2.11 | |
| Fasting Insulin (Cardiovascular mortality) | 1.4 |
Risk ratios comparing the highest category of fasting insulin or HOMA-IR to the lowest category for all-cause and cardiovascular mortality.
What it means
Insulin resistance as measured by HOMA-IR, but not fasting insulin, appears to be independently associated with a greater risk of cardiovascular or all-cause mortality in non-diabetic adults.
Limitations
The association of fasting insulin and HOMA-IR with cardiovascular mortality may be unreliable due to the small number of articles included for these specific associations.
The paper at a glance
| Magellan’s evidence label | Fasting insulin and HOMA-IR (our label for this citation — see PubMed for the paper’s own title and authors) |
|---|---|
| Journal | Biosci Rep |
| Year | 2017 |
| PMID | 28811358 ↗ |
| DOI | 10.1042/BSR20170947 ↗ |
| Topic | Metabolic health, glucose & body composition |
Read the source: PubMed record (authors, abstract, full citation) ↗ · Publisher via doi.org ↗
Where Magellan uses this paper
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Fasting Insulin / HOMA-IR Kit
Higher fasting insulin and HOMA-IR reflect greater insulin resistance, a central feature of metabolic syndrome that precedes and predicts type 2 diabetes and, in large cohorts and meta-analyses, is associated with increased risk of cardiovascular disease, all-cause and cardiovascular mortality, certain cancers, and…
The homeostatic model assessment of insulin resistance (HOMA-IR) is a simple index derived from a…
Research describes the compound or intervention studied. It is not a claim about any specific product.
Cite this page
These citations point at this summary. To cite the original paper with its full author list, use the PubMed record or doi.org.
Magellan Longevity. (2026). Is elevated fasting insulin or insulin resistance (HOMA-IR) associated with an increased risk of cardiovascular or all-cause mortality in non-diabetic adults? [Plain-English summary of Biosci Rep 2017, PMID 28811358, DOI 10.1042/BSR20170947]. Magellan Longevity. https://magellanlongevity.com/study/s145.html@misc{magellan_s145,
title = {Is elevated fasting insulin or insulin resistance (HOMA-IR) associated with an increased risk of cardiovascular or all-cause mortality in non-diabetic adults?},
author = {{Magellan Longevity}},
year = {2026},
howpublished = {\url{https://magellanlongevity.com/study/s145.html}},
note = {Plain-English summary of PubMed PMID 28811358; DOI 10.1042/BSR20170947; Biosci Rep 2017. Reviewed by Gabriel Radu, DO},
urldate = {2026-08-11}
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