Decreased glucose tolerance, not decreased insulin sensitivity, is a maturational abnormality in the male offspring of a parent with early coronary artery disease.
We investigated whether the male offspring of a parent with early coronary artery disease (before the age of 60; n = 61) exhibit decreased insulin sensitivity compared with controls matched for age and body mass index (BMI) (n = 39). The insulin sensitivity index (S[I]) was determined by the minimal modeling method of Bergman from a frequently sampled intravenous glucose tolerance test with intravenous tolbutamide. Offspring and controls had a similar S[I], insulin-independent glucose utilization (S[G]), first-phase insulin response (AIR[G]), and area under the glucose curve. When subjects were separated into two age groups, younger subjects aged 15 to 30 years and older subjects aged 31 to 45 years, important differences were seen. S[G] was significantly increased in younger offspring compared with controls (22.8 +/- 2.3 v 16.8 +/- 2.3 x 10(-3) x min(-1), P < .05). Older offspring had a significantly increased area under the glucose curve compared with controls (18,250 +/- 322 v 17,225 +/- 347 mg/dL x min(-1), P < .05). Older offspring also had decreased S[I] compared with younger offspring (5.0 +/- 0.4 v 6.6 +/- 0.9 x 10(-4) x min(-1) x micro U/mL, P < .05), but this difference was eliminated after adjusting for BMI and waist to hip ratio (5.5 +/- 0.4 v5.8 +/- 0.9 x 10(-3) x min(-1), nonsignificant). This study does not support the concept that insulin resistance is an early atherogenic risk factor in offspring at risk for coronary disease because of their family history. However, it does point to the importance of maturational changes in glucose homeostasis in these offspring.
Slyper
A H
AH
Medical College of Wisconsin, and St. Luke's Medical Center, Milwaukee, USA.
Zvereva
S
S
Pleuss
J
J
Hoffmann
R G
RG
Myers
T
T
Walker
J A
JA
D000293:Adolescent; D000328:Adult; D000375:Aging / Q000502:physiology*; D000818:Animals; D003327:Coronary Disease / Q000235:genetics*; D018149:Glucose Intolerance; D005951:Glucose Tolerance Test; D006168:Guinea Pigs; D006801:Humans; D007328:Insulin / Q000502:physiology*; D008074:Lipoproteins / Q000097:blood; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D008954:Models, Biological; D009994:Osmolar Concentration; D010290:Parents; D012016:Reference Values; D012727:Sex Characteristics
D007328:Insulin; D008074:Lipoproteins