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- November 20, 2008 |
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"What data is available that shows insulin resistance as a risk factor of CVD? How compelling is it?"Dr. Andrew P. Selwyn (biography)
English - 2004-06-04 - 12 minutes
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Summary :
Insulin resistance and atherosclerosis often appear together. Insulin resistance in these patients can be detected not only by sophisticated tests but by some simple observations of hypertension, hyperglycaemia and dyslipidemia involving small dense low-density lipoprotein (sdLDL) particles.
These patients also have slightly decreased high-density lipoprotein (HDL) levels, impaired fibrinolysis, a hypercoagulable state and increased inflammatory cytokine levels.
The San Antonio Heart Study found a significant relationship between the homeostasis model assessment of insulin resistance (HOMA-IR) and the risk of cardiovascular disease (CVD) outcomes over 8 years of follow up, in 2600 subjects free of CVD and type 2 diabetes at baseline. Another prospective study by Norhammar et al. was done on 181 patients admitted with myocardial infarction (MI) to the coronary care units of 2 Swedish hospitals. This study found high numbers of patients with impaired glucose tolerance (IGT) and newly diagnosed diabetes at discharge and 3 months following.
Copyright © 2004 E-MedHosting.com Inc.
Learning objectives :
After viewing these slides the particpant will be able to discuss:
- Clinical indicators of insulin resistance in patients with atherosclerosis
- Data from prospective studies showing:
-->the relationship of insulin resistance to CVD risk
-->the incidence of IGT and new onset diabetes in patients with MI
Bibliographic references :
Anthony J.G. Hanley, PhD, Ken Williams, MSc, Michael P. Stern, MD and Steven M. Haffner, MD.Homeostasis Model Assessment of Insulin Resistance in Relation to the Incidence of Cardiovascular Disease Diabetes Care 2002;25:1177-1184.
Anna Norhammar, Ĺke Tenerz, Göran Nilsson, Anders Hamsten, Suad Efendíc, Lars Rydén and Klas Malmberg.Glucose metabolism in patients with acute myocardial infarction and no previous diagnosis of diabetes mellitus: a prospective study The Lancet 2002;359(9324):2140-2144.
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