INSULIN-RESISTANCE IN PATIENTS WITH CARDI OVASCULAR RISK-FACTORS - ISAN EARLY DETECTION POSSIBLE

In the development of cardiovascular disease (CVD), insulin resistance (IR) seems to play a major role; several studies reported increased i nsulin levels in patients with CVD. As IR and hyperinsulinemia (HI) ar e also found in asymptomatic people it is believed, that the long last ing state of HI promotes macroangiopathy. Therefore, an early detectio n of IR could be a key stone for primary prevention. Aim: While in res earch the glucose-clamp technique is used to assess IR, this procedure is too costly for clinical practice. In the present study, we evaluat ed the use of a simultaneous determination of glucose (G) and insulin (I) during an oral glucose tolerance test (oGTT, 100 g) in cardiovascu lar risk patients (P) with normal glucose tolerance. Methods: 40 P wer e compared with 20 healthy volunteers (H). Venous blood samples for de termination of G and I were drawn at 0', 30', 60' and 120' min; fastin g levels of cholesterol, HDL and triglycerides were also taken, Insuli n was measured using a commercially available enzyme immune assay kit. Results: P showed significantly ( = p < 0.05) increased BMI (kg/m(2) ), systolic and diastolic blood pressure, triglycerides and total-chol esterol and a decreased HDL, when compared to H. While G0 was normal, G30, G60 and G120 were considerably elevated. Insulin levels were sig nificantly higher at all time points () in P. Discussion: Although P had up to two times higher I, they still showed a () worse glucose to lerance, when compared to H, - thus indirectly indicating IR. Whereas the conventional oGTT had not shown a clinically relevant disturbance, the additional measurement of insulin revealed excessive hyperinsulin emia. Thus, in these cardiovascular patients, the perilous metabolic s ydrome was detected via the additional determination of insulin during the oGTT. Before this procedure can be recommanded for clinical pract ice, however, further studies are needed.