Insulin Resistance and Fasting Hyperinsulinemia Are Risk Factors for New Cardiovascular Events in Patients With Prior Coronary Artery Disease and Normal Glucose Tolerance
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概要
- 論文の詳細を見る
Background Insulin resistance and hyperinsulinemia are important risk factors for coronary artery disease (CAD) and cardiovascular event (CVE). However, their independent relationship to new CVE in patients with normal glucose tolerance (NOT) and CAD is not known. Methods and Results Subjects of this 3-year observational study were 102 patients with CAD. Plasma glucose and insulin concentrations were determined at 2 time points (baseline and post oral glucose tolerance test [OGTT]. The fasting plasma glucose <110mg/dl and post-OGTT<140mg/dl was diagnosed as NGT (World Health Organization criteria). Insulin resistance was evaluated by the homeostasis model assessment of insulin resistance (HOMA-IR). Of the 102 patients, 23 had onset of new CVE, including 19 with new CAD. They had significantly higher fasting and post-OGTT insulin levels and HOMA-IR than those without new CVE (P<0.01, 0.031 and <0.01, respectively). Using the univariate Cox proportional hazards model, fasting and post-OGTT insulin values, HOMA-IR and high density lipoprotein (HDL) cholesterol differed significantly between the 2 groups. The multivariate Cox model showed that the effect of fasting plasma insulin and HOMA-IR remained significant and independent of HDL cholesterol. Conclusion Fasting hyperinsulinemia and high insulin resistance increased the risk of new CVE in patients with NGT and CAD.
- 社団法人日本循環器学会の論文
- 2003-12-20
著者
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Kato Tomoko
Division of Cardiology, National Cardiovascular Center
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Watarai Masato
School Of Health Sciences Nagoya University School Of Medicine
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Watanabe Makoto
Anjo Kosei Hospital
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Takatsu Fumimaro
Anjio Kosei Hospital
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Takatsu Fumimaro
Division Of Cardiology Department Of Internal Medicine Anjo Kosei Hospital
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Furuta Tatsuji
Department Of Cardiology Anjo Kosei Hospital
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Yanase Masanobu
Division of Transplantation, National Cardiovascular Center
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Yanase Masanobu
Department Of Cardiology Nagoya University Graduate School Of Medicine
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Watarai Masato
Department Of Cardiology Anjo Kosei Hospital
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Watari Masato
Division Of Cardiology Department Of Internal Medicine Anjo Kosei Hospital
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Tagawa Takayuki
Department of Radiological technology, Anjo Kosei Hospital
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Arai Kosuke
Division of Cardiology, Cardiovascular Center
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Koyasu Masayoshi
Division of Cardiology, Cardiovascular Center
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Horibe Hideki
Division of Cardiology, Cardiovascular Center
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Nomoto Shigeru
Division of Cardiology, Cardiovascular Center
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Takemoto Kenji
Division of Cardiology, Cardiovascular Center
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Shimizu Seiji
Division of Cardiology, Cardiovascular Center
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Watarai Masato
Division of Cardiology, Cardiovascular Center
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Arai Kosuke
Division Of Cardiology Cardiovascular Center
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Takemoto Kenji
Division Of Cardiology Cardiovascular Center
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Takemoto Kenji
Division Of Biological Sciences Graduate School Of Science Hokkaido University
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Watarai Masato
Division Of Cardiology Cardiovascular Center
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Kato Tomoko
Division Of Cardiology Cardiovascular Center
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Takatsu Fumimaro
Division Of Cardiology Cardiovascular Center
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Shimizu Seiji
Division Of Cardiology Cardiovascular Center
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Horibe Hideki
Division Of Cardiology Cardiovascular Center
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Nomoto Shigeru
Division Of Cardiology Cardiovascular Center
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Tagawa Takayuki
Department Of Radiological Technology Anjo Kosei Hospital
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Koyasu Masayoshi
Division Of Cardiology Cardiovascular Center
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