title: Clustering of impaired glucose tolerance, hyperinsulinemia and dyslipidemia in young north Indian patients with coronary heart disease: a preliminary case-control study.
abstract: Metabolic insulin resistance syndrome is a critical factor in the pathogenesis of atherosclerosis and coronary heart disease in Indians. In a preliminary case-control study, 44 young patients (age < 40 years) with coronary heart disease (angina, myocardial infarction), not previously diagnosed to have diabetes mellitus, were recruited seven days to six weeks after the cardiac event (group I), and compared to 20 healthy subjects (group II). After recording history and anthropometric data, they were subjected to oral glucose tolerance test. Each group was divided into A and B subgroups according to the magnitude of impaired glucose tolerance. Hypertension was recorded in 11 (25%) patients in group I, while all the subjects in group II were normotensive (p < 0.05). Groups IB and IIB, consisting of subjects with impaired glucose tolerance displayed significantly high post-load blood glucose values. After excluding patients with the family history of diabetes mellitus, there were 13 (39%) and 3 (17%) patients with impaired glucose tolerance in groups I and II, respectively. Total cholesterol and low-density lipoprotein cholesterol levels were higher in group I as compared to group II (p < 0.01). Group IB showed highest mean values of total cholesterol, triglycerides, low-density lipoprotein cholesterol and lowest level of high-density lipoprotein cholesterol as compared to other subgroups. Serum insulin levels at 30 and 90 minutes were significantly higher in group I (p < 0.05). Group IB and IIB showed higher insulin values at 90 minutes when compared to group IA (p < 0.05) and IIA (p < 0.05). Elevated serum insulin values at 90 minutes during oral glucose tolerance test could differentiate among both groups and subgroups, except IB versus IIB. The study demonstrates significantly high prevalence of hypertension, obesity, impaired glucose tolerance, hyperinsulinemia and dyslipidemia, suggesting fully developed metabolic insulin resistance syndrome in young north Indian patients with manifest coronary heart disease.
authors.affiliation: Department of Medicine, All India Institute of Medical Sciences, New Delhi.
authors.forename: A
authors.initials: A
authors.lastname: Misra
authors.forename: R B
authors.initials: RB
authors.lastname: Reddy
authors.forename: K S
authors.initials: KS
authors.lastname: Reddy
authors.forename: A
authors.initials: A
authors.lastname: Mohan
authors.forename: J S
authors.initials: JS
authors.lastname: Bajaj
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D016000:Cluster Analysis; D003327:Coronary Disease / Q000453:epidemiology*; D005260:Female; D018149:Glucose Intolerance / Q000453:epidemiology*; D006801:Humans; D006946:Hyperinsulinism / Q000453:epidemiology*; D006949:Hyperlipidemias / Q000453:epidemiology*; D007194:India / Q000453:epidemiology; D008297:Male; D012307:Risk Factors