TY - JOUR
T1 - Vascular insulin response is preserved in non-diabetic patients with coronary artery disease, despite endothelial dysfunction
AU - Ihlemann, Nikolaj
AU - Rask-Madsen, Christian
AU - Køber, Lars
AU - Torp-Pedersen, Christian
N1 - Keywords: Acetylcholine; Aged; Biological Markers; Blood Glucose; Blood Pressure; Coronary Artery Disease; Diabetes Mellitus; Dose-Response Relationship, Drug; Endothelium, Vascular; Female; Forearm; Heart Rate; Humans; Hypoglycemic Agents; Infusions, Intravenous; Insulin; Male; Middle Aged; Nitroprusside; Regional Blood Flow; Vasodilation; Vasodilator Agents
PY - 2004
Y1 - 2004
N2 - BACKGROUND--Patients with coronary artery disease (CAD) are often insulin resistant, a state that predisposes to increased atherosclerosis. Recently, it was suggested that a "vascular insulin resistance" could explain this association, causing endothelial dysfunction and hence atherosclerosis. We therefore studied the vascular insulin response in patients with CAD. MATERIALS AND METHODS--Nine non-diabetic patients with documented CAD and 31 lean healthy controls were examined. Forearm blood flow was measured by venous occlusion plethysmography. Dose-response studies of acetylcholine (ACh) and sodium nitroprusside (SNP) elicited endothelium-dependent and -independent vasodilation and were repeated during intra-arterial insulin infusion. RESULTS--Patients were insulin resistant as determined by HOMA index. Insulin infusion resulted in high physiological levels of insulin in the forearm without systemic effects. Patients had a reduced ACh response but insulin infusion increased the ACh response equally in patients and controls (a mean increase of 74+/-37 vs 57+/-24%, patients vs controls, p=0.12). A minor increase of the SNP response was also noted during insulin infusion. CONCLUSION--Vascular insulin response is intact in non-diabetic CAD patients in spite of insulin resistance and endothelial dysfunction.
AB - BACKGROUND--Patients with coronary artery disease (CAD) are often insulin resistant, a state that predisposes to increased atherosclerosis. Recently, it was suggested that a "vascular insulin resistance" could explain this association, causing endothelial dysfunction and hence atherosclerosis. We therefore studied the vascular insulin response in patients with CAD. MATERIALS AND METHODS--Nine non-diabetic patients with documented CAD and 31 lean healthy controls were examined. Forearm blood flow was measured by venous occlusion plethysmography. Dose-response studies of acetylcholine (ACh) and sodium nitroprusside (SNP) elicited endothelium-dependent and -independent vasodilation and were repeated during intra-arterial insulin infusion. RESULTS--Patients were insulin resistant as determined by HOMA index. Insulin infusion resulted in high physiological levels of insulin in the forearm without systemic effects. Patients had a reduced ACh response but insulin infusion increased the ACh response equally in patients and controls (a mean increase of 74+/-37 vs 57+/-24%, patients vs controls, p=0.12). A minor increase of the SNP response was also noted during insulin infusion. CONCLUSION--Vascular insulin response is intact in non-diabetic CAD patients in spite of insulin resistance and endothelial dysfunction.
U2 - 10.1080/14017430310016397
DO - 10.1080/14017430310016397
M3 - Journal article
C2 - 15204243
SN - 1401-7431
VL - 38
SP - 22
EP - 27
JO - Scandinavian Cardiovascular Journal
JF - Scandinavian Cardiovascular Journal
IS - 1
ER -