HYPERINSULINEMIA AND THE DEVELOPMENT OF ST-T ELECTROCARDIOGRAPHIC ABNORMALITIES - AN 11-YEAR FOLLOW-UP-STUDY

OBJECTIVE - It has been suggested that insulin resistance and conseque nt hyperinsulinemia promote atherosclerosis, but few prospective studi es have reported the relationships between hyperinsulinemia and the de velopment of ST-T abnormalities in the 12-lead resting electrocardiogr am (EGG) in populations in which atherosclerosis is rare. RESEARCH DES IGN AND METHODS - A total of 304 Japanese men and women, aged 20-69 ye ars, selected for having high blood glucose or more than a trace-posit ive urine glucose from a population-based health examination in 1981, were followed for 11 years. Of these, 33 died, 1 from myocardial infar ction, while 260/271 living were reexamined in 1992, The 237 subjects with a normal ECG at the baseline examination were analyzed. RESULTS - Incident ST-T abnormalities occurred in 13/237 people. Insulin concen trations were positively associated with the development of ST-T abnor malities (relative risk similar to 8, comparing those in the highest v ersus lowest quartile of insulin values). Adjustment for age, sex, and systolic blood pressure or other risk factors had little effect on th is relationship. CONCLUSIONS - Hyperinsulinemia was related to the dev elopment of ST-T abnormalities in ECGs in the absence of the developme nt of clinical signs of atherosclerosis, independent of blood pressure and other risk factors in men and women with mild glucose intolerance .