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Insulin resistance can be evaluated non-invasively by insulin sensitivity indices (ISI) such as the Mcauley index (MCAi), which is a function of the fasting insulin and triglycerides. Currently, the association between ISIs and ECG findings and all-cause and CV mortality is still not established in a large scale and heterogeneous population.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Method<\/jats:title>\n                <jats:p>In a prospective study of the Israel cohort on Glucose Intolerance, Obesity and Hypertension (GOH) second phase (1979\u20131982) 1830 men and women were followed until December-2016 for CV-mortality and December-2019 for all-cause mortality. ECGs were recorded and OGTTs performed during baseline. ISIs were categorized into quartiles and evaluated against ECG findings and all-cause and CV-mortality.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Mean age at baseline was 52.0\u2009\u00b1\u20098.1\u00a0years, and 75 (15.2%) and 47 (25.3%) participants in the upper quartiles (Q<jats:sub>2-4<\/jats:sub>) and the lower quartile (Q<jats:sub>1<\/jats:sub>) of the MCAi, presented with Ischemic changes on ECG respectively (<jats:italic>p<\/jats:italic>\u2009=\u20090.02). Multivariable analysis showed higher odds for ECG ischemic changes, for individuals in Q<jats:sub>1<\/jats:sub>-MCAi (adjusted-OR\u2009=\u20091.7, 95% CI 1.02\u20132.8), compared with Q<jats:sub>2-4<\/jats:sub>-MCAi, which attenuated when excluding individuals with diabetes (adjusted-OR\u2009=\u20091.6, 95% CI 0.9\u20132.7, <jats:italic>p<\/jats:italic>\u2009=\u20090.09).<\/jats:p>\n                <jats:p>Median follow up for all-cause and for cardiovascular mortality was 31\u00a0years and 37\u00a0years, respectively. Cox proportional-hazards regression showed an increased risk for all-cause mortality for individuals in Q<jats:sub>1<\/jats:sub>-MCAi (HR\u2009=\u20091.2, 95% CI 1.02\u20131.3) as well as an increased risk for CV-mortality (HR\u2009=\u20091.4, 95%CI 1.1\u20131.8) compared with Q<jats:sub>2-4<\/jats:sub>-MCAi. Individuals in Q<jats:sub>4<\/jats:sub>-Ln Homeostatic model assessment- Insulin Resistance (HOMA-IR) and Q<jats:sub>1<\/jats:sub>- Quantitative Insulin Sensitivity Check Index (QUICKI) also presented with increased risk for all-cause-mortality (HR\u2009=\u20091.2, 95%CI 1.04\u20131.4; and HR\u2009=\u20091.2, 95% CI 1.04\u20131.4, respectively). Other ISIs did not show significant associations with CV-mortality.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Higher insulin-resistance, according to the MCAi, associated with ECG-changes, and with greater risk for all-cause and CV-mortality over a 40-year follow-up. The MCAi may be considered as an early predictive and prognostic biomarker for CV-morbidity and mortality in adults.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12933-021-01284-9","type":"journal-article","created":{"date-parts":[[2021,5,6]],"date-time":"2021-05-06T19:02:35Z","timestamp":1620327755000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["The association between insulin sensitivity indices, ECG findings and mortality: a 40-year cohort study"],"prefix":"10.1186","volume":"20","author":[{"given":"Yonatan","family":"Moshkovits","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Rott","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Chetrit","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6454-6000","authenticated-orcid":false,"given":"Rachel","family":"Dankner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,5,6]]},"reference":[{"key":"1284_CR1","volume-title":"National diabetes statistics report, 2020","author":"Centers for Disease Control and Prevention","year":"2020","unstructured":"Centers for Disease Control and Prevention. 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