Tags

Type your tag names separated by a space and hit enter

Insulin resistance as a major determinant of increased coronary heart disease risk in postmenopausal women with Type 2 diabetes mellitus.
Diabet Med 2001; 18(6):476-82DM

Abstract

AIM

To investigate the risk factors associated with clinically defined coronary heart disease (CHD) in women with Type 2 diabetes mellitus (DM).

METHODS

CHD status was assessed via standard history and resting electrocardiogram in 41 postmenopausal diabetic and 41 age- and body mass index-matched normoglycaemic women recruited from a community-based cohort. The following parameters were assessed: body composition by dual energy X-ray absorptiometry, blood pressure, metabolic and lipoprotein profile and haemostatic factors.

RESULTS

Diabetic women with CHD (n = 14) had greater insulin resistance, calculated by homeostasis model assessment (10.2 (7.0-14.8) vs. 6.5 (5.5-7.7), P = 0.010), and higher plasminogen activator inhibitor-1 (PAI-1) levels (45 (29-69) vs. 24 (19-32) ng/ml, P = 0.013), than those without CHD. They also had higher triglycerides (2.9 (2.2-3.8) vs. 2.1 (1.8-2.4) mmol/l, P = 0.016) and a trend towards reduced low-density lipoprotein particle size (25.5 +/- 0.6 vs. 25.8 +/- 0.5 nm, P = 0.097). In a logistic regression model, insulin resistance was a significant independent predictor of CHD status (odds ratio = 1.33, 95% confidence interval = 1.06-1.68, P = 0.015). In contrast, in normoglycaemic women the major risk factors for CHD were elevated cholesterol, apolipoprotein(a), apolipoprotein B and systolic blood pressure (P = 0.018, P = 0.016, P = 0.006 and P = 0.049, respectively).

CONCLUSIONS

Increased insulin resistance in association with elevated PAI-1 and dyslipidaemia appears to underpin the increased risk of CHD in women with Type 2 DM. Therapeutic approaches that increase insulin sensitivity may serve to reduce CHD risk in this vulnerable group. Diabet. Med. 18, 476-482 (2001)

Authors+Show Affiliations

Nutrition Department, Alfred Hospital, Melbourne, Australia.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

11472467

Citation

Stoney, R M., et al. "Insulin Resistance as a Major Determinant of Increased Coronary Heart Disease Risk in Postmenopausal Women With Type 2 Diabetes Mellitus." Diabetic Medicine : a Journal of the British Diabetic Association, vol. 18, no. 6, 2001, pp. 476-82.
Stoney RM, O'Dea K, Herbert KE, et al. Insulin resistance as a major determinant of increased coronary heart disease risk in postmenopausal women with Type 2 diabetes mellitus. Diabet Med. 2001;18(6):476-82.
Stoney, R. M., O'Dea, K., Herbert, K. E., Dragicevic, G., Giles, G. G., Cumpston, G. N., & Best, J. D. (2001). Insulin resistance as a major determinant of increased coronary heart disease risk in postmenopausal women with Type 2 diabetes mellitus. Diabetic Medicine : a Journal of the British Diabetic Association, 18(6), pp. 476-82.
Stoney RM, et al. Insulin Resistance as a Major Determinant of Increased Coronary Heart Disease Risk in Postmenopausal Women With Type 2 Diabetes Mellitus. Diabet Med. 2001;18(6):476-82. PubMed PMID: 11472467.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Insulin resistance as a major determinant of increased coronary heart disease risk in postmenopausal women with Type 2 diabetes mellitus. AU - Stoney,R M, AU - O'Dea,K, AU - Herbert,K E, AU - Dragicevic,G, AU - Giles,G G, AU - Cumpston,G N, AU - Best,J D, PY - 2001/7/27/pubmed PY - 2001/10/12/medline PY - 2001/7/27/entrez SP - 476 EP - 82 JF - Diabetic medicine : a journal of the British Diabetic Association JO - Diabet. Med. VL - 18 IS - 6 N2 - AIM: To investigate the risk factors associated with clinically defined coronary heart disease (CHD) in women with Type 2 diabetes mellitus (DM). METHODS: CHD status was assessed via standard history and resting electrocardiogram in 41 postmenopausal diabetic and 41 age- and body mass index-matched normoglycaemic women recruited from a community-based cohort. The following parameters were assessed: body composition by dual energy X-ray absorptiometry, blood pressure, metabolic and lipoprotein profile and haemostatic factors. RESULTS: Diabetic women with CHD (n = 14) had greater insulin resistance, calculated by homeostasis model assessment (10.2 (7.0-14.8) vs. 6.5 (5.5-7.7), P = 0.010), and higher plasminogen activator inhibitor-1 (PAI-1) levels (45 (29-69) vs. 24 (19-32) ng/ml, P = 0.013), than those without CHD. They also had higher triglycerides (2.9 (2.2-3.8) vs. 2.1 (1.8-2.4) mmol/l, P = 0.016) and a trend towards reduced low-density lipoprotein particle size (25.5 +/- 0.6 vs. 25.8 +/- 0.5 nm, P = 0.097). In a logistic regression model, insulin resistance was a significant independent predictor of CHD status (odds ratio = 1.33, 95% confidence interval = 1.06-1.68, P = 0.015). In contrast, in normoglycaemic women the major risk factors for CHD were elevated cholesterol, apolipoprotein(a), apolipoprotein B and systolic blood pressure (P = 0.018, P = 0.016, P = 0.006 and P = 0.049, respectively). CONCLUSIONS: Increased insulin resistance in association with elevated PAI-1 and dyslipidaemia appears to underpin the increased risk of CHD in women with Type 2 DM. Therapeutic approaches that increase insulin sensitivity may serve to reduce CHD risk in this vulnerable group. Diabet. Med. 18, 476-482 (2001) SN - 0742-3071 UR - https://www.unboundmedicine.com/medline/citation/11472467/Insulin_resistance_as_a_major_determinant_of_increased_coronary_heart_disease_risk_in_postmenopausal_women_with_Type_2_diabetes_mellitus_ L2 - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=linkout&SEARCH=11472467.ui DB - PRIME DP - Unbound Medicine ER -