Plasma total homocysteine levels in subjects with hyperinsulinemia

Objectives. Hyperhomocysteinemia as well as insulin resistance are consider ed to be risk factors for the development of coronary artery disease. This study was aimed at determining whether any relationship between plasma insu lin and glucose levels and total plasma homocysteine (tHcy) concentrations exists in a population based survey performed 10 years apart. Design and Setting. A cross-sectional study was undertaken during the years 1986-87 to examine risk factors for diabetes and for coronary artery disea se (CAD) in the Jewish population of Jerusalem. Ten years later two groups of individuals were invited for re-examination. Subjects. Two groups of individuals were examined: the first one consisted of nondiabetic subjects (n = 86), who had hyperinsulinemia 10 years previou sly (at the first visit), the second group consisted of normoinsulinemic no ndiabetic individuals (n = 265) who had initially normal glucose and insuli n levels. Main outcome measures. Metabolic, biochemical and anthropomorphic features were determined. Fasting and post load glucose, as well as insulin concentr ations on fasting and 2 h post glucose load were measured at the first and second visits. Plasma tHcy and folic acid were determined only at the secon d visit. Results. The results demonstrated a significant negative correlation betwee n plasma tHcy levels and insulin levels at the second visit. No difference was found in folic acid levels between these two groups. Conclusions. In general, hyperinsulinemia and hyperhomocysteinemia are both related to an increased incidence of CAD. In our population most of the su bjects examined had tHcy levels within the normal range and only a few demo nstrated very high levels. However, negative association between insulin le vels and tHcy concentrations was found. Possible explanations for this find ing are discussed.