Vascular insulin response is preserved in non-diabetic patients with coronary artery disease, despite endothelial dysfunction

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 - 1401-7458

VL - 38

SP - 22

EP - 27

JO - Scandinavian Cardiovascular Journal, Supplement

JF - Scandinavian Cardiovascular Journal, Supplement

IS - 1

ER -