Variables of the insulin resistance syndrome are associated with reduced arterial distensibility in healthy non-diabetic middle-aged women

Abstract

Clustering of risk factors for cardiovascular disease (hypertension, obesity, dyslipidaemia), resistance to insulin-stimulated glucose uptake, and cardiovascular disease is known as the insulin resistance syndrome [1]. The insulin resistance syndrome occurs in non-insulin-dependent diabetic patients but also in non-diabetic people with normal glucose tolerance. In glucose-clamp studies in non-obese subjects with normal oral glucose tolerance, resistance to insulin-stimulated glucose uptake was found in approximately 25 % of these subjects [2]. These subjects secrete high Diabetologia (2000) Abstract Aims/hypothesis. The insulin resistance syndrome is related to arterial stiffness in diabetic subjects. Whether the insulin resistance syndrome is also related to arterial stiffness in non-diabetic subjects is less clear. We studied the association between variables of the insulin resistance syndrome in relation to arterial distensibility in healthy middle-aged non-diabetic women. Methods. This study was done in 180 non-diabetic women, aged 43±55, selected from the general population. Arterial distensibility was assessed in the carotid artery. The associations were evaluated using linear regression analyses. Results. Strong associations were found between arterial distensibility and the variables of the insulin resistance syndrome: body mass index, waist-to-hip ratio, high-density-lipoprotein-cholesterol, triglycerides, glucose, insulin, apolipoprotein A1, plasminogen activator inhibitor-1-antigen and tissue-type plasminogen activator-antigen. After additional adjustment for mean arterial pressure, common carotid arterial distensibility remained associated with body mass index: b-coefficient (95 % confidence interval) per kg/m 2 : ±0.24 (±0.42; ±0.06); waist-to-hip ratio: ±26.62 (±40.59; ±12.65) per m/m; triglycerides: ±1.42(±2.77; ±0.08) per mmol/l; plasminogen activator inhibitor±1-antigen: ±0.01 (±0.02; ±0.00) per ng/ml and borderline significant associated with high-density-lipoprotein-cholesterol: 1.93 (±0.01; 3.87; p = 0.07) per mmol/l. Clustering of variables of the insulin resistance syndrome was strongly related to decreased arterial distensibility which remained after adjustment for mean arterial pressure. No association was found between arterial distensibility and variables that are not part of the insulin resistance syndrome: total cholesterol, LDL-cholesterol and apolipoprotein B. Conclusion/interpretation. The results of this study show that variables of the insulin resistance syndrome are associated with decreased arterial distensibility of the common carotid artery in healthy non-diabetic subjects. [Diabetologia (2000)

Relation between insulin and aortic stiffness: a population-based study

“…Generally, a positive association has been found between insulin levels and arterial stiffness, but in many of these studies no adequate adjustments for HR were made. [28][29][30][31][32][33] However, in the three recently published studies, using the same methods as in the present study to measure PWV, no independent relationship between insulin and PWV could be identified after adjustment was made for SBP or mean BP, HR, sex, and age, 10-12 so at first glance our findings are not consistent with these results. Another finding that at first glance appears to be in contrast with the findings in the present study comes from Yki-Jarvinen and coworkers, who in different groups of subjects have shown that infusion of insulin producing acute hyperinsulinaemia leads to a marked decrease in large arterial stiffness.…”

“…1 Several other studies have examined the relationship between insulin and arterial stiffness. [15][16][17][18][28][29][30][31][32][33] Many different methods and indices have been used Table 4 because P>0.05: log of VLDL cholesterol, LDL cholesterol, HDL cholesterol, log of triglycerides, log of glucose, history of diabetes, diastolic BP, treatment of hypertension, BMI, waist/hip ratio, microalbuminuria, left ventricular mass index, smoking, alcohol consumption; X vs o5 beverages per day, physical activity.…”

The metabolic syndrome in elderly individuals is associated with greater muscular, but not elastic arterial stiffness, independent of low-grade inflammation, endothelial dysfunction or insulin resistance—The Hoorn Study

“…TG, triglycerides; HDL, high-density lipoprotein cholesterol; BP, blood pressure; MetS, metabolic syndrome. muscular and elastic arteries within the same group of individuals in contrast to most, 5,6,[9][10][11][12][14][15][16] but not all, 7,8,13 earlier studies, which examined arterial stiffness at only one arterial site [14][15][16] or at one arterial segment. 5,6,[9][10][11][12]16 Our data suggest that increased arterial stiffness may link the MetS to CVD and is in general agreement with the above studies.…”

“…3 The term arterial stiffness refers to an impairment in the cushioning function of the artery (that is, a diminished ability to convert the pulsatile blood flow from the heart into a steady and continuous stream throughout the arterial tree), which leads to increased systolic blood pressure, left ventricular hypertrophy, impaired coronary perfusion and arterial stiffness-associated CVD (notably, stroke, heart failure and myocardial infarction), 4 and can be measured both locally (at a single location within the artery wall) or regionally (over a prespecified arterial segment, for example, the carotid-femoral tract). Earlier studies on arterial stiffness in the MetS [5][6][7][8][9][10][11][12][13][14][15][16] have raised several issues. Firstly, there is some evidence that, in the MetS, increases in arterial stiffness may not be uniformly distributed over muscular (that is, peripheral) and elastic (that is, central) arteries.…”

“…Firstly, there is some evidence that, in the MetS, increases in arterial stiffness may not be uniformly distributed over muscular (that is, peripheral) and elastic (that is, central) arteries. 7,8,13 The interpretation of the literature, however, is hampered by the fact that most studies reported arterial stiffness in only one site [14][15][16] or segment, 5,6,[9][10][11][12] whereas studies that did report on multiple sites 8 or segments 7,13 showed discordant results. Secondly, the MetS is associated with insulin resistance (IR), a proinflammatory state and endothelial dysfunction (ED), 17 and it has been suggested that these phenomena play an important role in the complex pathobiology of arterial stiffening.…”