INCREASED RISK-FACTORS FOR CORONARY-ARTERY DISEASE IN JAPANESE SUBJECTS WITH HYPERINSULINEMIA OR GLUCOSE-INTOLERANCE

OBJECTIVE- To understand the interrelationship of coronary artery dise ase (CAD) risk factors including hyperlipidemia, hypertension, and glu cose intolerance to prevent and better manage this disease. RESEARCH D ESIGN AND METHODS- We performed a 100-g oral glucose tolerance test in 2,113 subjects, and we evaluated their plasma lipid levels, blood pre ssure (BP), and plasma glucose and plasma insulin responses. RESULTS- Multiple regression analysis demonstrated a significant relationship o f either BP, plasma triglyceride (TG), or high-density lipoprotein (HD L) cholesterol levels to plasma insulin and glucose response after the glucose load. Plasma cholesterol levels were related only to the plas ma glucose response. In subjects matched for age, sex, and body mass i ndex (BMI) with hyperinsulinemia or normoinsulinemia, the hyperinsulin emic subjects had a significantly higher mean BP and plasma TG level t han the normoinsulinemic subjects (128.8/82.3 vs. 122.9/79.3 mmHg and 172.1 vs. 119.4 mg/dl), and the HDL-cholesterol level was significantl y lower (43.9 vs. 47.8 mg/dl). Furthermore, subjects matched for age, sex, and BMI with glucose intolerance had a higher mean BP (128.4/81.8 vs. 123.5/78.7 mmHg) and higher plasma TG level (154.2 vs. 123.0 mg/d l) than those without glucose intolerance. CONCLUSIONS- Based on these findings, subjects with hyper-insulinemia or glucose intolerance shou ld be carefully managed to prevent CAD, because they have more numerou s and more severe risk factors than subjects with normal plasma insuli n levels or subjects without glucose intolerance.