Cardiovascular risk factors associated with insulin resistance cluster in families with early-onset coronary heart disease

Coronary heart disease (CHD) is a multifactorial disease caused by environm ental and genetic factors. CHID clusters in families, but it is not known w hether susceptibility to early-onset CHD is associated with the clustering of cardiovascular risk factors. Therefore, we determined the levels of card iovascular risk factors among siblings with and without severe early-onset CHD drawn from 101 Finnish families. Probands with CHD, compared with their siblings without CHD, had, respectively, higher 2-hour insulin levels (475 .7 versus 331.8 pmol/L, P=0.011) and 2-hour insulin areas (796.2 versus 640 .4 pmol/L per hour, P=0.031) in an oral glucose tolerance test, lower high density lipoprotein cholesterol levels (1.22 versus 1.42 mmol/L, P=0.001), higher total triglyceride levels (1.91 versus 1.68 mmol/L, P=0.018), higher very low density lipoprotein triglyceride. levels (1.25 versus 1.06 mmoL/L , P=0.011), and higher fibrinogen levels (3.8 versus 3.4 g/L, P=0.008). No significant differences were found in cardiovascular risk factors between a ffected siblings and probands with CHD. Environmental or lifestyle factors did not differ between siblings with or without early-onset CHD. We conclud e that cardiovascular risk factors associated with the insulin resistance s yndrome (hyperinsulinemia, low high density lipoprotein cholesterol, high t otal and very low density lipoprotein triglycerides, and high fibrinogen) a re likely to contribute indirectly to early-onset CHID.