Relationship of plasma insulin levels to the incidence of myocardial infarction and coronary heart disease mortality in a middle-aged population

Ducimetière, Pierre; Eschwège, É.; Papoz, L; Richard, J. L.; Claude, Jean‐Roger; Rosselin, G

doi:10.1007/bf00275270

Cited by 716 publications

(186 citation statements)

References 24 publications

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“…In the Helsinki Policemen study post-load insulin levels were independent risk factors for coronary heart disease, 3 whereas in the Paris Prospective study of male sub-jects aged 43-54 years, an increased level of fasting insulin was associated with an increased risk of coronary disease independent of other risk factors. 4 Thus, the subjects in these studies were much younger than our study group in which the mean age of the subjects was 66 years. Furthermore, another population-based study with the mean age of 67 years, also failed to recognise fasting or plasma insulin following a glucose load as cardiovascular risk factors.…”

Section: Discussionmentioning

confidence: 66%

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Should we do an oral glucose tolerance test in hypertensive men with normal fasting blood-glucose?

Agewall

2000

J Hum Hypertens

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The objective of this study was to examine, using the new WHO criteria for diabetes mellitus, whether insulin and glucose before and after an oral glucose tolerance test would predict cardiovascular mortality in hypertensive men with normal fasting blood glucose. A standard oral glucose challenge was performed after an overnight fast in 113 hypertensive men with either hypercholesterolaemia or smoking. These patients were recruited from an on-going risk factor intervention study. The mean observation time was 6.3 years. During follow-up there were 10 cardiovascular deaths. The Cox regression analyses showed an independent and significant association (P Ͻ 0.05) between blood glucose 120 min

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Section: Discussionmentioning

confidence: 66%

“…1,2 There are also studies suggesting hyperinsulinaemia, but not hyperglycaemia as a major cardiovascular risk factor. 3,4 However not all studies have found that hyperinsulinaemia is a cardiovascular risk factor. 5 Others have found that hyperglycaemia following oral glucose tolerance test predict coronary heart disease.…”

Section: Introductionmentioning

confidence: 99%

Should we do an oral glucose tolerance test in hypertensive men with normal fasting blood-glucose?

Agewall

2000

J Hum Hypertens

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“…Chronic hyperglycaemia might also increase the risk for coronary artery disease by many mechanisms, such as abnormalities in lipoprotein particle composition, irreversible glycation of proteins in the arterial wall [54], acceleration of thrombus formation [54] and oxidation of lipoproteins [55] or worsening of insulin resistance and hyperinsulinaemia [56]. Consistent with that many [20,21,22,23] but not all studies [57,58] have found that higher HbA 1c is a predictor for macrovascular complications.…”

Section: Discussionmentioning

confidence: 74%

The effects of insulin and short-term hyperglycaemia on myocardial blood flow in young men with uncomplicated Type I diabetes

et al. 2002

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Aims/hypothesis. Insulin enhances coronary vasodilation in healthy subjects. We tested whether insulin is able to induce coronary vasodilation in Type I (insulin-dependent) diabetic mellitus patients. Additionally, the effect of short-term hyperglycaemia on myocardial perfusion was studied. Methods. Myocardial blood flow was quantitated basally and during adenosine infusion (140 µg/kg per min iv) with or without simultaneous insulin infusion (1 mU/kg per min for 60 min) in nine non-smoking Type I diabetic males (HbA 1c 7.4±1.0%) without diabetic complications and 10 healthy non-diabetic otherwise matched males using positron emission tomography and 15 O-water. Diabetic patients were studied on two occasions, once during normoglycaemia (plasma glucose ~6 mmol/l) and once during hyperglycaemia (~10 mmol/l) induced by reducing the dose of insulin for two days. Results. Resting myocardial blood flow was similar in the studied groups (NS). Hyperaemic adenosine stimulated flow was 23% lower in diabetic than in nondiabetic subjects (3.09±0.72 vs 4.0±1.13 ml·g -1 ·min -1 , p<0.05). Insulin increased significantly adenosine stimulated flow by 23% in diabetic and 17% in nondiabetic subjects (NS between the groups). Hyperglycaemia for two days had no effect on flow values when compared to the values during normoglycaemia (NS). Conclusion/interpretation. Insulin has similar vasodilative effects on coronary arteries in diabetic and nondiabetic subjects. Short-term hyperglycaemia does not alter myocardial blood flow or abolish insulin induced vasodilation in these patients. Insulin induced coronary vasodilation might contribute to the known beneficial effect of intensive insulin therapy on myocardial ischaemia in diabetic patients. [Diabetologia (2002) 45:775-782] Keywords Type I diabetes, myocardial perfusion, coronary vasoreactivity, insulin, hyperglycaemia, positron emission tomography.

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“…Regulating insulin levels may be important not only in diabetic patients, but also in healthy subjects as hyperinsulinemia has been directly associated with CHD in previously healthy populations (Ducimetiere et al, 1980;Pyorala et al, 1985;Despres et al, 1996). Hyperinsulinemia has recently been found to moderately increase cardiovascular mortality in middle-age men (Lakka et al, 2000) and insulin resistance, a risk factor for CHD (Reaven, 1993) has been shown to respond to manipulations of the dietary GI (Frost et al, 1998).…”

Section: The Glycemic Index In Coronary Heart Diseasementioning

confidence: 99%

Glycemic index in chronic disease: a review

et al. 2002

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Aim: The intent of this review is to critically analyze the scientific evidence on the role of the glycemic index in chronic Western disease and to discuss the utility of the glycemic index in the prevention and management of these disease states. Background: The glycemic index ranks foods based on their postprandial blood glucose response. Hyperinsulinemia and insulin resistance, as well as their determinants (eg high energy intake, obesity, lack of physical activity) have been implicated in the etiology of diabetes, coronary heart disease and cancer. Recently, among dietary factors, carbohydrates have attracted much attention as a significant culprit, however, different types of carbohydrate produce varying glycemic and insulinemic responses. Low glycemic index foods, characterized by slowly absorbed carbohydrates, have been shown in some studies to produce beneficial effects on glucose control, hyperinsulinemia, insulin resistance, blood lipids and satiety. Method: Studies on the short and long-term metabolic effects of diets with different glycemic indices will be presented and discussed. The review will focus primarily on clinical and epidemiological data, and will briefly discuss in vitro and animal studies related to possible mechanisms by which the glycemic index may influence chronic disease.

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Relationship of plasma insulin levels to the incidence of myocardial infarction and coronary heart disease mortality in a middle-aged population

Cited by 716 publications

References 24 publications

Should we do an oral glucose tolerance test in hypertensive men with normal fasting blood-glucose?

Should we do an oral glucose tolerance test in hypertensive men with normal fasting blood-glucose?

The effects of insulin and short-term hyperglycaemia on myocardial blood flow in young men with uncomplicated Type I diabetes

Glycemic index in chronic disease: a review

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