TUMOR-NECROSIS-FACTOR-BETA ALLELES AND HYPERINSULINEMIA IN CORONARY-ARTERY DISEASE

Background Hyperinsulinaemia and dyslipoproteinaemia are markers and r isk factors for coronary artery disease (CAD) and non-insulin-dependen t diabetes mellitus (NIDDM). We investigated the influence of a tumour necrosis factor beta (TNF-beta) gene polymorphism on serum parameters related to these metabolic disorders in patients with CAD. Methods A total of 199 patients with CAD and 81 control subjects with angiograph ically normal coronary arteries were studied. A digestion of amplified DNA with NcoI revealed three fragment patterns: homozygosity for TNF- beta1 or TNF-beta*2 and heterozygosity (TNF-beta*1/*2). Results Patie nts with CAD who had increased serum insulin or C-peptide (fasting and after glucose load) were predominantly heterozygous for TNF-beta (72% vs. 47%) and less frequently homozygous for TNF-beta2 (22% vs. 43%, P=0.03). Conclusion This study demonstrates an association of TNF-beta alleles with the risk factor hyperinsulinaemia in CAD. Genomic varian ts of TNF-beta may therefore contribute to the complex susceptibility for the metabolic syndrome in patients with CAD.