Background:
@EN Recent studies suggest that hyperinsulinemia may be an important risk factor for ischemic coronary heart disease(CHD). Whether the relation between hyperinsulinemia and CHD is independent of related risk factors, such as hypertriglyceridemia,
low
HDL cholesterol concentrations, and hypertension,is not clear. The purpose of this study was to compare the differences of plasma insulin level and various CHD risk factors between 31 normotensive, non-diabetic patients with angiographically
demonstrated CHD, and age and body mass index(BMI) matched 45 healthy controls, and determine the relationships between insulin levels and various CHD risk factors.
@ES Methods:
@EN Anthropometric parameters and blood pressure(BP), smoking amount, nutrients intake, serum levels of lipids were decremined in all subjects, 75 gm oral glucose tolerence tests were performed with serial blood sampling to measure plasma
glucose,
insulin and C-peptide levels, and response area of glucose(glucose area), insulin (Insulin area) and C-peptide(C-peptide area) were calculated.
@ES Results:
@EN 1) Mean age of patients group was 56.9±1.4 years and mean body mass index was 26.1±0.4 ㎏/㎡.
2) Waist to hip circumference ratio(WHR),amount of smoking, and systolic BP levels of patients were higher than those of controls(0.99±0.10 vs. 0.96±0.01, p<0.05, 18.9±3.3 vs. 8.6±2.3 pack ?yr, p<0.01; 13.9±3.4 vs. 125.8±2.1 mmHg, p<0.01,
respectively). Fasting C-peptide and LDL-cholesterol (LDL-C), glucose area, insulin are, and C-peptide and LDL-cholesterol (LDL-C), glucose area, insulin area, and C-peptide area of patients were higher (2.2±0.2 vs. 1.4±0.2ng/ml, p<0.01;
137.2±7.9
vs. 1.4±0.2ng/ml, p<0.01; 137.2±7.9 vs. 105.3±7.3 ㎎/dl, p<0.01; 277.7±12.7 vs. 227.5±11.7 ㎎/dl×hr,p<0.01; 97.5±11.0 vs. 65.8±5.8 uU/ml×hr, p<0.05; 10.3±0.7 vs. 6.1±0.3 ng/ml×hr, p<0.001, respectively) than those of control. But
HDL-cholesterol (HDL-C) level and glucose area/insulin area ratio of patients were lower(37.1±2.3 vs. 48.3±3.1 ㎎/dl, p<0.01; 2.19±0.51 vs. 3.46±0.34, p<0.01, respectively) than those of controls.
3) Among the coronary risk factors, fasting insulin level was significantly correlated with total cholesterol(TC), HDL-C and triglyceride(TG) levels (r=0.4374, p<0.05; r=-0.4007, p<0.05; r=0.4604, p<0.01, respectively), and insulin area with
systolic
and diastolic BPs, TC, LDL-C, HDL-C and TG levels(r=0.2883, p<0.05; r=0.4193, p<0.01; r=0.5370, p<0.01; r=0.4490, p<0.01; r=-0.330, p<0.04; r=0.4281, p<0.01, respectively).
4) After multiple linear regression analysis with coronary risk factors, age was the most important variable for systolic BP and HDL-C, and insulin area for diastolic BP, TC, LDL-C and TG levels and WHR for fasting insulin and insulin area.
@ES Conclusion:
@EN Our results showed that hyperinsulinemia demonstrated in normotensive, non-diabetic patients with angiographically demonstrated CHD, was significantly related with multiple coronary risk factors including central obesity, dyslipidemia,
smoking
amount and hypertension. And out results also support the notion that maintaining and adequate level of insulin sensitivity and low plasma insulin concentrations through proper diet and exercise habits, may reduce the risk of coronary heart
disease.
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