Postchallenge hyperglycemia but not hyperinsulinemia is associated with angiographically documented coronary atherosclerosis in Korean subjects.
Although hyperinsulinemia has attracted considerable attention as a possible risk factor for coronary artery disease (CAD), previous studies have not shown consistent results. Hyperglycemia could be an alternative explanation for the association between type 2 diabetes and atherosclerosis. Since previous studies have been mostly lacking coronary angiographic data, we analyzed the relationship between the presence and severity of coronary atherosclerosis based on angiography and hyperinsulinemia or hyperglycemia. Two hundred and thirty subjects underwent coronary angiography and a 75-g oral glucose tolerance test. Age, sex, waist-to-hip ratio, postchallenge 1-h and 2-h glucose levels, plasma triglyceride and HDL-cholesterol levels were different between those with or without CAD. However, there was no significant difference in the plasma insulin levels, area of insulin under the curve, and the ratio of the insulin- and glucose areas between the groups with and without CAD. Multiple logistic regression analysis including fasting-, 1-h, and 2-h glucose values and a variety of atherosclerosis risk factors showed that age, sex and postchallenge 2-h glucose levels were independent determinants of the presence of CAD. These results suggest that coronary atherosclerosis might be associated with postchallenge hyperglycemia, but not with hyperinsulinemia in Korean subjects.
Kim
Hong-Kyu
HK
Department of Internal Medicine, Gachon Medical School, Gil Medical Center, Inchon, South Korea.
Lee
Sung-Kwang
SK
Suh
Chan-Jong
CJ
Yoon
Hyo-Joong
HJ
Lee
Ki-Young
KY
Park
Hye-Young
HY
Kang
Moon-Ho
MH
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000378:metabolism; D002097:C-Reactive Protein / Q000378:metabolism; D002784:Cholesterol / Q000097:blood; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000097:blood / Q000150:complications*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications*; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D006943:Hyperglycemia / Q000097:blood / Q000150:complications*; D006946:Hyperinsulinism / Q000097:blood / Q000150:complications*; D007328:Insulin / Q000097:blood; D007723:Korea; D008297:Male; D008875:Middle Aged; D012737:Sex Factors; D014280:Triglycerides / Q000097:blood
D001786:Blood Glucose; D007328:Insulin; D014280:Triglycerides; D002097:C-Reactive Protein; D002784:Cholesterol