Abstract
Background: We planned a case-control study to assess the relation of fasting glucose, fasting
insulin, postprandial glucose and postprandial insulin levels with coronary artery
disease in nondiabetic women. Methods: Among 968 consecutive nondiabetic women screened, 104 with coronary artery disease
(mean age 60, 4±9) made up the study cohort (group I). One-hundred and four age-matched,
nondiabetic women without coronary artery disease who had a similar lipid and blood
pressure profile (group II), and 52 healthy, age-matched women served as controls
(group III, real control group). Demographics, waist circumference, lipids, fasting
glucose postprandial glucose, fasting and postprandial insulin levels were compared
among the groups. A separate subgroup analysis were performed in patients with metabolic
syndrome. Results: No differences were identified in terms of prevalences of risk factors between group
I and group II. Women with coronary artery disease had higher postprandial insulin
level than the women in group II and group III. In reverse stepwise logistic regression
analysis postprandial hyperinsulinemia was found to be the single independent determinant
for coronary artery disease for the entire study group as well as for women with metabolic
syndrome. Conclusion: Our data demonstrate that postprandial hyperinsulinemia is independently associated
with coronary artery disease, irrespective of fasting glucose, postprandial glucose,
and fasting insulin levels in nondiabetic women with clusterings of factors of metabolic
syndrome.
Keywords
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References
- Hypertriglyceridemia, atherogenic dyslipidemia, and the metabolic syndrome.Am J Cardiol. 1998; 81: 18B-25B
- Clustering of cardiovascular risk factors: targeting high-risk individuals.Am J Cardiol. 1995; 76: 8A-20A
- Impact of multiple risk factor profiles on determining cardiovascular disease risk.Prev Med. 1998; 27: 1-9
- How deadly is the ‘deadly quartet’? A post-CABG review.J Am Coll Cardiol. 2000; 36: 1159-1165
- Relation between insulin resistance, hyperinsulinemia, postheparin plasma lipoprotein lipase activity, and postprandial lipemia.Arterioscler Thromb Vasc Biol. 1995; 15: 320-324
- Coronary heart disease mortality in relation with diabetes, blood glucose and plasma insulin levels: the Paris Prospective Study, 10 years later.Horm Metab Res Suppl. 1985; 15: 41-46
- Hyperinsulinemia as an independent risk factor for ischemic heart disease.N Engl J Med. 1996; 334: 952-957
- Hyperinsulinemia predicts coronary heart disease risk in healthy middle-aged men: the 22-year follow-up results of the Helsinki Policeman Study.Circulation. 1998; 98: 398-404
- Insulin and risk of cardiovascular disease: a meta-analysis.Circulation. 1998; 97: 996-1001
- Hyperinsulinemia does not increase the risk of fatal cardiovascular disease in elderly men or women without diabetes: the Rancho Bernardo Study, 1984–1991.Am J Epidemiol. 1994; 140: 857-869
- Coronary heart disease incidence and cardiovascular mortality in Busselton with reference to glucose and insulin concentrations.Diabetes Care. 1979; 2: 154-160
- Executive Summary of the Third Report of the National Cholesterol Education Program Expert Panel on Detection Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III).J Am Med Assoc. 2001; 285: 2486-2497
- Diabetes and cardiovascular disease. The ‘common soil’ hypothesis.Diabetes. 1995; 44: 369-374
- Endothelial-dependent vascular effects of insulin and insulin-like growth factor I in the perfused rat mesenteric artery and aortic ring.Diabetes. 1994; 43: 1027-1032
- Insulin, insulin-like growth factor I and platelet-derived growth factor interact additively in the induction of the protooncogene c-myc and cellular proliferation in cultured bovine aortic smooth muscle cells.Mol Endocrinol. 1989; 3: 1183-1190
- Decreased effect of insulin to stimulate sceletal muscle blood flow in obese man: a novel mechanism for insulin resistance.J Clin Invest. 1990; 85: 1844-1852
- Cardiovascular risk continuum: implications of insulin resistance and diabetes.Am J Med. 1998; 105: 4S-14S
- Coronary artery disease is associated with low insulin sensitivity independent of insulin levels and cardiovascular risk factors.Diabetes. 1996; 45 (abstract): 52A
- Insulin resistance syndrome predicts coronary heart disease events in elderly non-diabetic men.Circulation. 1999; 100: 123-128
Article info
Publication history
Accepted:
July 20,
2002
Received in revised form:
July 1,
2002
Received:
October 29,
2001
Identification
Copyright
© 2002 Elsevier Science Ireland Ltd. Published by Elsevier Inc. All rights reserved.
