title: Insulin response to oral glucose load is associated with coronary artery disease in subjects with normal glucose tolerance.
abstract: OBJECTIVE
  The critical role of hyperinsulinemia, independent of hyperglycemia, in the pathogenesis of atherosclerosis has not been fully determined. We investigated the association between secretion patterns of insulin after oral glucose load and the severity of coronary artery disease (CAD) in patients with normal glucose tolerance (NGT).
  
  
  METHODS
  We enrolled 116 subjects with NGT from 243 patients who had undergone coronary angiography and a standard 75-g oral glucose tolerance test. The patients were divided into 0-vessel, single-vessel and multi-vessel disease groups on the basis of the severity of CAD.
  
  
  RESULTS
  The 2-h insulin levels in the multi-vessel disease group (p=0.005) and the single-vessel disease group (p<0.05) were significantly higher than those in the 0-vessel disease group. Multivariate analysis revealed that the levels of 2-h insulin were an independent variable for the presence of CAD (p=0.02) after adjustment for gender and the presence of each criterion of metabolic syndrome using the definition of the International Diabetes Federation.
  
  
  CONCLUSIONS
  A slight but significant increase in prolonged insulin secretion, which is associated with the early stage of insulin resistance, in subjects with NGT, may play an important role in the pathogenesis of atherosclerosis.
authors.affiliation: Department of Cardiovascular Medicine, Juntendo University School of Medicine, Tokyo, Japan. testuro@med.juntendo.ac.jp
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Miyazaki
authors.forename: Kazunori
authors.initials: K
authors.lastname: Shimada
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Iwama
authors.forename: Atsumi
authors.initials: A
authors.lastname: Kume
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Sumiyoshi
authors.forename: Yayoi
authors.initials: Y
authors.lastname: Sato
authors.forename: Hirotoshi
authors.initials: H
authors.lastname: Ohmura
authors.forename: Yoshiro
authors.initials: Y
authors.lastname: Watanabe
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Mokuno
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Daida
mesh_terms: D000328:Adult; D000368:Aged; D050197:Atherosclerosis / Q000209:etiology*; D003324:Coronary Artery Disease / Q000209:etiology*; D005260:Female; D005947:Glucose / Q000378:metabolism; D005951:Glucose Tolerance Test; D006801:Humans; D006943:Hyperglycemia / Q000150:complications*; D006946:Hyperinsulinism / Q000150:complications*; D007328:Insulin / Q000378:metabolism*; D007333:Insulin Resistance; D000078790:Insulin Secretion; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index
chemical_list: D007328:Insulin; D005947:Glucose