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Insulin resistance and coronary artery disease
Open accessAbstract
The purpose of the present study was to quantitate insulin-mediated glucose disposal in normal glucose tolerant patients with angiographically documented coronary artery disease (CAD) and to define the pathways responsible for the insulin resistance. We studied 13 healthy, normal weight, normotensive subjects with angiographically documented CAD and 10 age-, weight-matched control subjects with an oral glucose tolerance test and a 2-h euglycaemic insulin (40 mU.m-2.min-1) clamp with tritiated glucose and indirect calorimetry. Lean body mass was measured with tritiated water. All CAD and control subjects had a normal oral glucose tolerance test. Fasting plasma insulin concentration (66 +/- 6 vs 42 +/- 6 pmol/l, p < 0.05) and area under the plasma insulin curve following glucose ingestion (498 +/- 54 vs 348 +/- 42 pmol.l-1.min-1, p < 0.001) were increased in CAD vs control subjects. Insulin-mediated whole body glucose disposal (27.8 +/- 3.9 vs 38.3 +/- 4.4 mumol.kg fat free mass (FFM)-1.min-1, p < 0.01) was significantly decreased in CAD subjects and this was entirely due to diminished non-oxidative glucose disposal (8.9 +/- 2.8 vs 20.0 +/- 3.3 mumol.kg FFM-1.min-1, p < 0.001). The magnitude of insulin resistance was positively correlated with the severity of CAD (r = 0.480, p < 0.05). In the CAD subjects basal and insulin-mediated rates of glucose and lipid oxidation were normal and insulin caused a normal suppression of hepatic glucose production. In conclusion, subjects with angiographically documented CAD are characterized by moderate-severe insulin resistance and hyperinsulinaemia and should be included in the metabolic and cardiovascular cluster of disorders that comprise the insulin resistance syndrome or "syndrome X'.
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“Insulin resistance in skeletal muscle also can develop independent of family history of T2DM.”
From Pathogenesis of insulin resistance in skeletal muscle (2010) · cites this paper as [36]
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“Thus, obese NGT subjects without a family history for T2DM [33, 34] and individuals with essential hypertension [35] and ischemic heart disease [36] also have a 35–50% decrease in whole body insulin-mediated glucose disposal (Figure 3).”
From Pathogenesis of insulin resistance in skeletal muscle (2010) · cites this paper as [36]
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Role of Insulin Resistance in Human Disease
Reaven, G. M. (1988) · Diabetes · doi:10.2337/diab.37.12.1595 · Cited by 12,154
Glucose clamp technique: a method for quantifying insulin secretion and resistance.
DeFronzo, R. A., Tobin, J. D., & Andres, R. (1979) · American Journal of Physiology-Endocrinology and Metabolism · doi:10.1152/ajpendo.1979.237.3.e214 · Cited by 7,425
Self-citationDeFronzo, R. A., & Ferrannini, E. (1991) · Diabetes Care · doi:10.2337/diacare.14.3.173 · Cited by 4,555
Self-citationBanting lecture 1988. Role of insulin resistance in human disease.
Reaven, G. (1988) · Diabetes · doi:10.2337/diabetes.37.12.1595 · Cited by 3,801
Insulin Resistance in Essential Hypertension
Ferrannini, E., Buzzigoli, G., Bonadonna, R., Giorico, M. A., Oleggini, M., Graziadei, L., Pedrinelli, R., Brandi, L., & Bevilacqua, S. (1987) · New England Journal of Medicine · doi:10.1056/nejm198708063170605 · Cited by 2,344
Pathogenesis of NIDDM. A balanced overview.
DeFronzo, R. A., Bonadonna, R. C., & Ferrannini, E. (1992) · Diabetes Care · doi:10.2337/diacare.15.3.318 · Cited by 2,085
Self-citationHyperinsulinemia as an independent risk factor for ischemic heart disease
Després, J.-P., Lamarche, B., Mauriège, P., Cantin, B., Dagenais, G. R., Moorjani, S., & Lupien, P.-J. (1996) · New England Journal of Medicine · doi:10.1056/nejm199604113341504 · Cited by 1,699
Shulman, G. I., Rothman, D. L., Jue, T., Stein, P., DeFronzo, R. A., & Shulman, R. G. (1990) · New England Journal of Medicine · doi:10.1056/nejm199001253220403 · Cited by 1,248
Self-citationHyperinsulinaemia: the key feature of a cardiovascular and metabolic syndrome
Ferrannini, E., Haffner, S. M., Mitchell, B. D., & Stern, M. P. (1991) · Diabetologia · doi:10.1007/bf00403180 · Cited by 898
Measurement of Size and Turnover Rate of Body Glucose Pool by the Isotope Dilution Method
Steele, R., Wall, J. S., de Bodo, R. C., & Altszuler, N. (1956) · American Journal of Physiology-Legacy Content · doi:10.1152/ajplegacy.1956.187.1.15 · Cited by 816
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Obstructive Sleep Apnea Is Independently Associated with Insulin Resistance
Ip, M. S. M., Lam, B., Ng, M. M. T., Lam, W. K., Tsang, K. W. T., & Lam, K. S. L. (2002) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/ajrccm.165.5.2103001 · Cited by 1,300
DeFronzo, R. A. (2010) · Diabetologia · doi:10.1007/s00125-010-1684-1 · Cited by 908
Self-citationInsulin resistance and hyperglycaemia in cardiovascular disease development
Laakso, M., & Kuusisto, J. (2014) · Nature Reviews Endocrinology · doi:10.1038/nrendo.2014.29 · Cited by 884
Pathogenesis of insulin resistance in skeletal muscle
Abdul-Ghani, M. A., & DeFronzo, R. A. (2010) · Journal of Biomedicine and Biotechnology · doi:10.1155/2010/476279 · Cited by 670
Self-citationSurrogate markers of insulin resistance: A review
Singh, B. (2010) · World Journal of Diabetes · doi:10.4239/wjd.v1.i2.36 · Cited by 622
Metadata
- Authors
- Bressler, P., Bailey, S. R., Matsuda, M., & DeFronzo, R. A.
- Affiliations
- The University of Texas at San Antonio Health Science Center (US)
- Venue
- Diabetologia
- Published
- 1996-10-23
- Volume
- 39
- Issue
- 11
- Pages
- 1345-1350
- ISSN
- 0012-186X (ISSN-L)
- 1432-0428
- OpenAlex
- W2017443146
- Cited by
- 226
- References
- 47
- Citations by year
- 2026: 1 · 2025: 11 · 2024: 6 · 2023: 6 · 2022: 21 · 2021: 3 · 2020: 2 · 2019: 6 · 2018: 3 · 2017: 4 · 2016: 4 · 2015: 5 · 2014: 7 · 2013: 3 · 2012: 5
- FWCI
- 8.06
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Diabetologia (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Deutsches Krebsforschungszentrum
- National Institutes of Health (AM 24 092, 5r01am024092-06)
- Geriatric Research Education and Clinical Center
- National Center for Research Resources (M01RR01346, M01RR001346)
- NIH Clinical Center
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diet, Metabolism, and Disease
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Pancreatic function and diabetes
- Keywords
- insulin resistance, coronary artery disease, insulin-stimulated glucose disposal, hyperinsulinemia, metabolic syndrome, hepatic glucose production, glucose oxidation, lipid oxidation, fasting insulin
- MeSH terms
- Blood Glucose, Coronary Disease, Coronary Vessels, Fatty Acids, Nonesterified, Female, Glucose, Glucose Tolerance Test, Humans, Insulin, Insulin Resistance, Male, Middle Aged, Triglycerides, Lipid Peroxidation, Body Mass Index, Case-Control Studies
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