Evaluation of glucose tolerance, post-prandial hyperglycemia and hyperinsulinemia influencing the incidence of coronary heart disease.
BACKGROUND
Recently, the frequency of patients who have glucose intolerance has been increasing in Japan. Glucose intolerance and insulin resistance/hyperinsulinemia are thought to influence the progression of atherosclerosis. The present study examined glucose tolerance, insulin resistance, post-prandial hyperglycemia/hyperinsulinemia and coronary risk factors by using 75 g oral glucose tolerance test (OGTT).


METHODS
Coronary risk factors were examined and OGTT with measurement of plasma glucose and serum insulin was done to evaluate the glucose metabolism and insulin resistance in 263 patients who underwent coronary angiography; 202 subjects were diagnosed as having coronary heart disease (CHD) and 61 subjects were normal. We compared the two groups.


RESULTS
The rate of having diabetes was significantly high in the CHD group. From the result of OGTT, 22.3% of CHD patients had diabetes mellitus and 36.6% had impaired glucose tolerance, thus the total glucose intolerance rate was 57.7% in the CHD group. No significant difference was noted in the homeostatic model assessment-R (HOMA-R), but glucose and insulin at 2 hours after OGTT were all significantly high in the CHD group.


CONCLUSIONS
The rate of glucose intolerance and the levels of post-prandial glucose and insulin were high in the CHD group. We concluded that the post-prandial hyperglycemia and hyperinsulinemia influenced the incidence of CHD.
Yamasa
Toshihiko
T
Department of Cardiology, Sasebo Municipal General Hospital, Sasebo, Japan. t-yamasa@hospital.sasebo.nagasaki.jp
Ikeda
Satoshi
S
Koga
Seiji
S
Kawahara
Eisuke
E
Muroya
Takahiro
T
Shinboku
Hiroki
H
Kohno
Shigeru
S
D000368:Aged; D003327:Coronary Disease / Q000453:epidemiology / Q000209:etiology*; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000175:diagnosis / Q000453:epidemiology; D005260:Female; D018149:Glucose Intolerance / Q000150:complications* / Q000453:epidemiology; D005951:Glucose Tolerance Test; D006801:Humans; D006943:Hyperglycemia / Q000150:complications* / Q000175:diagnosis; D006946:Hyperinsulinism / Q000150:complications*; D015994:Incidence; D008297:Male; D008875:Middle Aged; D019518:Postprandial Period; D012307:Risk Factors