RELATIONSHIP BETWEEN INSULIN-RESISTANCE AND RISK-FACTORS FOR CARDIOVASCULAR-DISEASE IN JAPANESE NON-INSULIN-DEPENDENT DIABETIC-PATIENTS

To investigate whether a resistance to insulin-stimulated glucose upta ke (IR) is associated with the risk factors (RF) for cardiovascular di sease (CVD) in non-insulin-dependent diabetic (NIDDM) patients, we det ermined the degree of IR in 135 adult NIDDM patients who had no advanc ed diabetic complications. The euglycemic (80 mg/dl) hyperinsulinemic clamp (insulin infusion rate 1.12 mU/kg per min) was performed and the average glucose infusion rate (GIR) during a steady-state euglycemia was determined as a measure of IR. Hypertension was more common among NIDDM patients with an increased IR and was highest in the group of pa tients with CVD. CVD-RF such as hypertension, hypertriglyceridemia, lo w HDL-cholesterol and obesity tended to cluster in the NIDDM patients who had lower GIR values and higher fasting IRI levels. GIR values wer e compared between a set of groups extracted from the 135 NIDDM patien ts that were matched for age, sex, body mass index and HbA(1c) levels. The CVD-positive group had the significantly lower GIR value than the CVD-negative group (2.06 +/- 0.66 vs. 3.45 +/- 1.75, P < 0.005). The GIR value was also significantly lower in the hypertriglyceridemic gro up compared with the normotriglyceridemic group (2.50 +/- 1.36 vs. 4.0 3 +/- 1.82, P < 0.0005). However, there was no significant difference between the hypertensive and normotensive groups and between the high cholesterol or low HDL-cholesterol groups and their respective control groups. In conclusion, these results suggest that IR contributes to t he clustering of CVD-RFs which may accelerate the development of CVD i n the subgroup of Japanese NIDDM patients.