Hyperinsulinemia predicts multiple atherogenic changes in lipoproteins in elderly subjects.
Several studies have shown that hyperinsulinemia and insulin resistance are associated with high triglyceride and low high-density lipoprotein (HDL) cholesterol levels. However, previous studies have been cross-sectional, and thus the presence of hyperinsulinemia or insulin resistance could be a consequence of the underlying lipid disorder instead of its cause. Therefore, we examined the relation of fasting insulin level measured in a cross-sectional study in nondiabetic subjects 65 to 74 years old (n = 881) to the risk of developing lipid disorders 3.5 years later. The incidence of the following lipid abnormalities was calculated: hypertriglyceridemia (n = 49/732, incident cases/subjects free of the particular disorder at baseline), high low-density lipoprotein (LDL) cholesterol level (n = 43/696), low HDL cholesterol level (n = 33/708), high apolipoprotein (apo) B level (n = 72/699), low apoAI level (n = 47/711), low serum LDL cholesterol/serum apoB ratio (n = 55/685), and low serum HDL cholesterol/serum apoAI ratio (n = 48/707). Baseline insulin level was not significantly associated with the development of high LDL cholesterol or low HDL cholesterol levels. Baseline insulin was associated with the development of hypertriglyceridemia (odds ratio [OR], 1.64; 95% confidence interval [CI], 1.12 to 2.40; P = .011), high apoB (OR, 1.54; 95% CI, 1.13 to 2.10; P = .006), low apoAI (OR, 1.72; 95% CI, 1.22 to 2.42; P = .002), low LDL cholesterol/apoB ratio (OR, 1.99; 95% CI, 1.36 to 2.90; P < .001), and low HDL cholesterol/apoAI ratio (OR, 1.93; 95% CI, 1.34 to 2.79; P < .001).(ABSTRACT TRUNCATED AT 250 WORDS)
Mykkänen
L
L
Department of Medicine, University of Kuopio, Finland.
Kuusisto
J
J
Haffner
S M
SM
Pyörälä
K
K
Laakso
M
M
D000368:Aged; D000375:Aging / Q000097:blood*; D001053:Apolipoproteins / Q000378:metabolism; D001161:Arteriosclerosis / Q000209:etiology*; D015992:Body Mass Index; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D003430:Cross-Sectional Studies; D005215:Fasting; D005260:Female; D005544:Forecasting; D018149:Glucose Intolerance; D006801:Humans; D006946:Hyperinsulinism / Q000097:blood*; D007328:Insulin / Q000097:blood; D008074:Lipoproteins / Q000097:blood*; D008297:Male; D011446:Prospective Studies; D014280:Triglycerides / Q000097:blood
D001053:Apolipoproteins; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D007328:Insulin; D008074:Lipoproteins; D014280:Triglycerides