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

Summary

The possible role of plasma insulin levels as a risk factor of coronary heart disease has been studied in a population of 7246 non diabetic, working men, aged 43–54 years, initially free from heart disease, and followed for 63 months on average. 128 new coronary heart disease events (non fatal myocardial infarction and coronary related deaths) were detected during this period. The annual risk is analysed by a multivariate model including age, serum cholesterol and triglycerides, blood pressure, smoking, obesity, plasma glucose and insulin fasting and 2 hours after a 75 g oral glucose load. It is shown that the fasting plasma insulin level and the fasting insulin-glucose ratio are positively associated with risk independent of the other factors. The same variables, 2 hours after the glucose load are also positively associated with risk but their contributions are not significant in the multivariate analysis. It is concluded that high insulin levels may constitute an independent risk factor for coronary heart disease complications in middle aged non diabetic men.

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References

  1. West KM (1978) Specific morbid effects (complications): atherosclerosis and related disorders. In: West KM (ed) Epidemiology of diabetes and its vascular lesions. Elsevier, New York, p 353–402
    Google Scholar
  2. Epstein FM (1967) Hyperglycaemia — A risk factor in coronary heart disease. Circulation 36: 609–619
    Google Scholar
  3. Stout RW, Vallance-Owen J (1969) Insulin and atheroma. Lancet I: 1078–1080
    Google Scholar
  4. Stout RW (1977) The relationship of abnormal circulating insulin levels to atherosclerosis. Atherosclerosis 27: 1–13
    Google Scholar
  5. Stout RW (1979) Diabetes and atherosclerosis — The role of insulin. Diabetologia 16: 141–150
    Google Scholar
  6. Richard JL, Ducimetiere P, Bonnaud G, Claude JR, Lellouch J, Schwartz D, Di Matteo J (1977) Incidence et évaluation du risque de maladie coronazienne. L'Etude Prospective Parisienne. Arch Mal Coeur 70: 531–537
    Google Scholar
  7. Tran MH, Richard JL, Lellouch J (1973) La graisse d'une population masculine Française active de 4000 sujets de 46–52 ans. Pathol Biol 21: 747–754
    Google Scholar
  8. Etienne G, Papin JP, Renault M (1963) Une méthode simple de dosage du cholesterol par voie automatique. Ann Biol Clin 21: 851–853
    Google Scholar
  9. Claude JR, Corre F (1968) Considerations pratiques sur le dosage semi automatique des triglycerides sériques par fluorometrie (méthode de Kessler et Lederer). Comparaison avec la méthode manuelle colorimétrique de Van Handel et Zilversmit. Ann Biol Clin 26: 451–454
    Google Scholar
  10. Methodologie Technicon Auto-Analyser “N” 2a, 2ème ed. Décembre 1963
  11. Rosselin G, Assan R, Yalow RS, Berson SA (1966) Séparation of antibody bound and unbound peptide hormone labelled with iodine 131 by talcum powder and precipitates silica. Nature 212: 355–357
    Google Scholar
  12. Rosselin G, Claude JR, Eschwege E, Patois E, Warnet JM, Richard JL (1971) Diabetes survey, plasma insulin during 0–2 h oral glucose tolerance test systematically carried out in a professional group. Diabetologia 7: 34–45
    Google Scholar
  13. Lellouch J, Rakotovao R (1976) L'estimation d'une courbe de risque comme une fonction de variables prédictives. I. Description de la méthode. Rev Epidem Santé Publ 24: 123–130
    Google Scholar
  14. Ducimetiere P, Richard JL, Rakotovao R, Claude JR (1976) L'estimation d'une courbe de risque comme une fonction de variables prédictives. II. Application à l'analyse multivariate du risque de cardiopathies ischémiques dans une population masculine active d'âge moyen. Rev Epidem Santé Publ 24: 131–140
    Google Scholar
  15. Epstein FM (1967) Some uses of prospective observations in the Tecumseh Community Health Study. Proc R Soc Med 60: 56–61
    Google Scholar
  16. Keen H, Jarrett RJ (1973) Macroangiopathy — Its prevalence in asymptomatic diabetes. Arch Metab Dis (Suppl) 2: 3–9
    Google Scholar
  17. International Collaborative Group: Glycaemia and coronary heart disease: Introduction to a series of papers reporting findings from fifteen population studies. J Chronic Dis 32: 683–837
  18. Fuller J, Mc Cartney P, Jarrett RJ, Keen H, Rose G, Shipley MJ, Hamilton PJS (1979) Hyperglycaemia and coronary heart disease: the Whitehall Study. J Chronic Dis 32: 721–728
    Google Scholar
  19. Ducimetiere P, Eschwege E, Richard JL, Claude JR, Elgrishi I (1979) Relationship of glucose tolerance to prevalence of ECG abnormalities and to annual mortality from cardiovascular diseases: Results of the Paris Prospective Study. J Chronic Dis 32: 759–766
    Google Scholar
  20. Pyorälä K, Nikkilä EA, Taskinen MR, Sutanen P, Punsar S (1979) Plasma insulin as coronary heart disease risk factor. Comm. to the 2nd Scientific Meeting of the Working Group on the Epidemiology and Prevention of Cardiovascular Diseases of the European Society of Cardiology, Dublin, 5–7 April 1979
  21. Pyorälä K (1979) Relationship of glucose tolerance and plasma insulin to the incidence of coronary heart disease: Results from two population studies in Finland. Diabetes Care 2: 131–141
    Google Scholar
  22. Welborn TA, Wearne K (1979) Coronary heart disease incidence and cardiovascular mortality in Busselton with refernce to glucose and insulin concentrations. Diabetes Care 2: 154–160
    Google Scholar
  23. Peters N, Hales CN (1972) Plasma insulin concentrations after myocardial infarction. Lancet I: 1144–1145
    Google Scholar
  24. Nikkilä EA, Miettinen AA, Vesenne MR, Pelkonen R (1965) Plasma insulin in coronary heart disease. Lancet II: 508–511
    Google Scholar
  25. Reaven GM, Olefsky JM (1978) Role of insulin resistance in the pathogenesis of hyperglycaemia. In: Katzen MM, Mahler RJ (eds) Diabetes, obesity, and vascular disease. Halsted Press, Washington, p 229–266
    Google Scholar
  26. Perley M, Kipnis DM (1966) Plasma insulin responses to glucose and tolbutamide of normal weight and obese diabetic and non diabetic subjects. Diabetes 15: 867–873
    Google Scholar
  27. Seltzer NJ, Allen W, Herron AL, Brennan MT (1967) Insulin secretion in response to glycemic stimulus: relation of delayed initial release to carbohydrate intolerance in mild diabetes mellitus. J Clin Invest 46: 1954–1962
    Google Scholar
  28. Sorge F, Schwartzkopff W, Neuhaus GA (1976) Insulin response to oral glucose in patients with a previous myocardial infarction and in patients with peripheral vascular disease. Diabetes 25: 586–594
    Google Scholar
  29. Santen RJ, Willis PW, Fajans SS (1972) Atherosclerosis in diabetes mellitus. Correlations with serum lipids levels, adiposity and serum insulin level. Arch Intern Med 130: 833–843
    Google Scholar
  30. Heyden S (1975) The problem with triglycerides. Nutr Metab 18: 1–3
    Google Scholar
  31. Gordon T, Castelli WP, Hjortland MC, Kannel WB, Dawber TR (1977) Diabetes, blood lipids and the role of obesity in coronary heart disease risk for women. The Framingham Study. Ann Intern Med 87: 393–397
    Google Scholar
  32. Wilhelmsen L, Vedel H, Tibblin G (1973) Multivariate analysis of risk factors for coronary heart disease. Circulation 48: 950–954
    Google Scholar
  33. Carlson LA, Bottiger LE (1972) Ischemic heart diseases in relation to fasting values of plasma triglycerides and cholesterol. Lancet I: 863–867
    Google Scholar
  34. Blackburn H (1974) Progress in the epidemiology and prevention of coronary heart disease. In: Yu P, Goodwin J (eds) Progress in cardiology. Lea and Febiger, Philadelphia, p 1–15
    Google Scholar

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Authors and Affiliations

  1. Groupe d'Etude sur l'Epidémiologie de l'Athérosclérose, Paris, France
    P. Ducimetiere, E. Eschwege, L. Papoz, J. L. Richard, J. R. Claude & G. Rosselin
  2. 169 INSERM, 16 bis, avenue PV Couturier, F-94800, Villejuif, France
    P. Ducimetiere

Authors

  1. P. Ducimetiere
  2. E. Eschwege
  3. L. Papoz
  4. J. L. Richard
  5. J. R. Claude
  6. G. Rosselin

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Ducimetiere, P., Eschwege, E., Papoz, L. et al. Relationship of plasma insulin levels to the incidence of myocardial infarction and coronary heart disease mortality in a middle-aged population.Diabetologia 19, 205–210 (1980). https://doi.org/10.1007/BF00275270

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