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[The relationship among proinsulin and true insulin to coronary artery disease]
1Department of Cardiology, Henan Provincial People's Hospital, Zhengzhou 450003, China.
Insights
Proinsulin (PI) and true insulin (TI) levels, while elevated in coronary artery disease (CAD) patients compared to controls, do not appear to be independently associated with CAD risk. Adjustments for metabolic factors further diminished any observed links.
Area of Science:
- Endocrinology
- Cardiovascular Medicine
- Metabolic Research
Context:
- Coronary artery disease (CAD) is a leading cause of mortality worldwide.
- Insulin resistance and glucose metabolism are implicated in cardiovascular disease pathogenesis.
- The independent role of proinsulin (PI) and true insulin (TI) in CAD remains unclear.
Purpose:
- To investigate the independent association between proinsulin (PI) and true insulin (TI) levels and the presence of coronary artery disease (CAD).
Summary:
- This study analyzed PI and TI concentrations in patients with diagnosed CAD, patients without CAD, and healthy volunteers using a sensitive BA-ELISA assay.
- Fasting and post-glucose loading PI and TI levels were significantly higher in both CAD and non-CAD groups compared to controls.
- After adjusting for age, BMI, and waist-hip ratio, these associations weakened or disappeared, with no significant differences found between the CAD and non-CAD groups.
Impact:
- Findings suggest that PI and TI may not be independent risk factors for CAD.
- Highlights the importance of considering confounding metabolic factors when evaluating the relationship between insulin markers and cardiovascular disease.
- Further research may be needed to elucidate the complex interplay between insulin dynamics and atherosclerosis.
Objective:
Whether proinsulin (PI) and true insulin (TI) are independently related to coronary artery disease (CAD).
Methods:
54 patients with CAD diagnosed by coronary angiography and/or intravascular ultrasound, 37 patients without CAD by coronary angiography and/or intravascular ultrasound and 23 healthy volunteers. All subjects had oral glucose tolerance test after an overnight 14 h fast. PI and TI concentrations were detected at different phases by BA-ELISA in which PI cross -reactivity is less than 0.1%.
Results:
Fasting and post-glucose loading PI and TI levels in both CAD and non-CAD groups significantly increased when compared with the control group (P < 0.05), after adjustment for age, body mass index and waist hip ratio, all statistically significant associations weakened or disappeared among three groups; but there was no significant difference of all the above variables between CAD group and non-CAD group (P > 0.05).
Conclusion:
PI and TI, whether fasting or post-glucose loading, may not be independently related to CAD.