Firefighters, heart disease, and aspects of insulin resistance: the FEMA Firefighter Heart Disease Prevention study.

Objective: To determine the association of cardiovascular risk markers with noninvasive imaging of atherosclerosis in firefighters. Methods: Crosssectional investigation of subclinical atherosclerosis with metabolic, work related, and life-style variables in 296 professional firefighters. Results: Calcified coronary atherosclerosis (CAC), carotid arterial intimal thickness (CIMT), and electrocardiogram provided independent CVD assessments. Homeostatic Model Assessment (HOMA) concentrations were related to heart-rate-corrected QT (QTc) (slope ± SE: 2.16 ± 65, P = 0.001), average common CIMT (0.019 ± 0.005 mm,P =0.0005), and total CAC lesions (0.269 ± 0.116, P = 0.02). Stepwise linear regression selected fasting insulin as the strongest predictor for QTc, HOMA as the strongest predictor of average CIMT, and fasting glucose as the strongest predictor of total coronary lesion number and score. Conclusion: Firemen’s HOMA and fasting insulin and glucose concentrations were significantly associated with three measures of CVD. Aspects of insulin resistance are related to CVD risk among firefighters.