title: Intima-media thickness of the carotid arteries in subjects with hyperinsulinaemia (insulin resistance).
abstract: The metabolic syndrome is characterised by hyperinsulinaemia (insulin resistance) leading to an increased risk of atherosclerotic cardiovascular diseases. Carotid intima-media thickness (IMT) can be easily measured to detect early atherosclerosis. In order to evaluate the clinical characteristics of the metabolic syndrome a screening procedure was performed and carotid IMT was determined by high-resolution B-mode ultrasonography in a cohort of middle-aged (40-60 years) subjects who proved to be hyperinsulinaemic [fasting plasma insulin >15 microU/ml and/or post-prandial (120 min) insulin > 45 microU/ml; n = 91; men/women: 35/56; homeostasis model assessment (HOMA)-index: 6.42 +/- 3.65; x +/- SD]. Subjects known to have diabetes were not involved. Subjects were divided into subgroups according to the stages of glucose intolerance (normal glucose tolerance, n = 46; impaired glucose tolerance, n = 26; diabetes mellitus, n = 19). As controls, age- and sex-matched non-diabetic and non-hyperinsulinaemic subjects (n = 20; HOMA-index: 2.09 +/- 0.85) were investigated. The values of IMT of the internal carotid arteries were higher in hyperinsulinaemic subjects than in controls (0.93 +/- 0.39 mm vs 0.57 +/- 0.13 mm,p < 0.001), whereas the lumen diameter proved to be smaller than in control subjects (5.04 +/- 0.75 mm vs 5.45 +/- 0.71 mm; p < 0.05). In hyperinsulinaemic subjects only a trend of increasing IMT values and that of decreasing lumen diameter of the internal carotid arteries were observed when subgroups classified according to the stages of glucose intolerance were compared. No significant changes in IMT or lumen diameter of the common carotid arteries were observed. Early and asymptomatic signs of atherosclerosis could be detected in middle-aged subjects who proved to be hyperinsulinaemic in a screening procedure. The prevention of clinically manifest cardiovascular diseases in these subjects could be of great importance.
authors.affiliation: Medical Department, Bajcsy-Zsilinszky Hospital, Budapest, Hungary.
authors.forename: T
authors.initials: T
authors.lastname: Hidvégi
authors.forename: F
authors.initials: F
authors.lastname: Szatmári
authors.forename: K
authors.initials: K
authors.lastname: Hetyési
authors.forename: L
authors.initials: L
authors.lastname: Bíró
authors.forename: G
authors.initials: G
authors.lastname: Jermendy
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure / Q000502:physiology; D002340:Carotid Artery Diseases / Q000097:blood / Q000503:physiopathology; D017536:Carotid Artery, Common / Q000378:metabolism / Q000473:pathology* / Q000503:physiopathology*; D015331:Cohort Studies; D003404:Creatinine / Q000097:blood; D005215:Fasting / Q000097:blood; D005260:Female; D006801:Humans; D006814:Hungary / Q000453:epidemiology; D006946:Hyperinsulinism / Q000097:blood / Q000503:physiopathology*; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance / Q000502:physiology; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D013223:Statistics as Topic; D017539:Tunica Intima / Q000378:metabolism / Q000473:pathology* / Q000503:physiopathology*
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D007328:Insulin; D008055:Lipids; D003404:Creatinine