title: Effect of glycemic state on postprandial hyperlipidemia and hyperinsulinemia in patients with coronary artery disease.
abstract: Both postprandial hyperlipidemia and hyperinsulinemia have been thought to play an important role in the development of atherosclerosis, and to be a potent risk factor for cardiovascular event. To examine effects of glycemic state on postprandial hyperlipidemia and hyperinsulinemia in patients with coronary artery disease (CAD), a total of 112 consecutive male pati ents with angiographically confirmed CAD were loaded with a high-fat and high-glucose test meal. CAD patients were divided into three groups as "non-diabetic", "prediabetic", and "diabetic" CAD groups. The serum triglyceride (TG) and remnant-like particle cholesterol (RLP-C) levels at the 6th hour in diabetic CAD group showed significantly higher than non-diabetic CAD group, and the incremental area under the curves (iAUCs) of these levels in diabetic CAD group were significantly greater than non-diabetic CAD group (TG, P = 0.0194; RLP-C, P = 0.0219). There were no significant differences in the iAUCs of TG or RLP-C between prediabetic and non-diabetic CAD group. The AUCs of plasma insulin levels or insulin resistance index (IRI): (AUCs of insulin) × (AUCs of glucose) as the insulin resistance marker were greater in diabetic CAD group than non-diabetic CAD group (insulin, P = 0.0373; IRI, P = 0.0228). The AUCs of serum TG or RLP-C levels showed a correlation with the AUCs of plasma insulin (AUC-TG, r = 0.5437, P < 0.0001; AUC-RLP-C, r = 0.6847, P < 0.0001), and they correlated well with the insulin resistance index (AUC-TG, r = 0.7724, P < 0.0001; AUC-RLP-C, r = 0.7645, P < 0.0001). We found that the insulin resistance showed a close relationship with postprandial hyperlipidemia in CAD patients. Diabetic, but not prediabetic state, may be a risk for postprandial impaired lipid metabolism in CAD patients.
authors.affiliation: Department of Cardiology, Iwate Prefectural Central Hospital, 1-4-1 Ueda, Morioka, 020-0066, Japan. akihiro-nakamura@pref.iwate.jp.
authors.forename: Akihiro
authors.initials: A
authors.lastname: Nakamura
authors.affiliation: Department of Cardiology, Iwate Prefectural Central Hospital, 1-4-1 Ueda, Morioka, 020-0066, Japan.
authors.forename: Yuto
authors.initials: Y
authors.lastname: Monma
authors.affiliation: Department of Cardiology, Iwate Prefectural Central Hospital, 1-4-1 Ueda, Morioka, 020-0066, Japan.
authors.forename: Shoko
authors.initials: S
authors.lastname: Kajitani
authors.affiliation: Department of Cardiology, Iwate Prefectural Central Hospital, 1-4-1 Ueda, Morioka, 020-0066, Japan.
authors.forename: Kazuki
authors.initials: K
authors.lastname: Noda
authors.affiliation: Department of Cardiology, Iwate Prefectural Central Hospital, 1-4-1 Ueda, Morioka, 020-0066, Japan.
authors.forename: Sota
authors.initials: S
authors.lastname: Nakajima
authors.affiliation: Department of Cardiology, Iwate Prefectural Central Hospital, 1-4-1 Ueda, Morioka, 020-0066, Japan.
authors.forename: Hideaki
authors.initials: H
authors.lastname: Endo
authors.affiliation: Department of Cardiology, Iwate Prefectural Central Hospital, 1-4-1 Ueda, Morioka, 020-0066, Japan.
authors.forename: Tohru
authors.initials: T
authors.lastname: Takahashi
authors.affiliation: Department of Cardiology, Iwate Prefectural Central Hospital, 1-4-1 Ueda, Morioka, 020-0066, Japan.
authors.forename: Eiji
authors.initials: E
authors.lastname: Nozaki
mesh_terms: D000368:Aged; D019540:Area Under Curve; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism*; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000097:blood* / Q000150:complications / Q000000981:diagnostic imaging; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000150:complications / Q000175:diagnosis; D004040:Dietary Carbohydrates / Q000008:administration & dosage; D004041:Dietary Fats / Q000008:administration & dosage; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D006946:Hyperinsulinism / Q000097:blood* / Q000175:diagnosis / Q000209:etiology; D006949:Hyperlipidemias / Q000097:blood* / Q000175:diagnosis / Q000209:etiology; D007328:Insulin / Q000097:blood*; D007333:Insulin Resistance; D008055:Lipids / Q000097:blood*; D008297:Male; D008875:Middle Aged; D019518:Postprandial Period; D011236:Prediabetic State / Q000097:blood / Q000175:diagnosis; D012372:ROC Curve; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D004040:Dietary Carbohydrates; D004041:Dietary Fats; D006442:Glycated Hemoglobin; D007328:Insulin; D008055:Lipids; C517652:hemoglobin A1c protein, human
keywords: Coronary artery disease; Diabetes; Hyperinsulinemia; Insulin resistance; Postprandial hyperlipidemia