[Carbohydrate tolerance, serum insulin and triglycerides in coronary disease]

The authors set up the task to study the changes in blood sugar, immunoreactive insulin and triglycerides in patients with manifested coronary disease during an oral glucoso-tolerance test in the course of three hours. They examined 32 patients with coronary disease and 19 control subjects, similar in age and body weight, divided into three subgroups: with normal glucose tolerance (NGT), suspiciously-pathological glucose tolerance (SPGT) and pathological glucose tolerance (PGT). They are led by age conformed criteria in the assessment of the blood sugar curves obtained. For a better idea about the insulin response volume, provoked by glucose loading, they compare the sums of the insulinemic values and "insulinogenic index", among the control subjects and the patients examined. The study of the carbohydrate tolerance of the patients examined, show that manifested or suspiciously pathological deviations in carbohydrate metabolism were found in almost 60% of them. Insulinemia during the glucose loading was found to be higher than that of the control subjects, maximal point appearing later and restoration to initial values delayed. The highest absolute insulin values and increased volume of insulin secretion were established in the patients with NGT and the lowest--in patients with PGT. The highest insulinogenic index is in NGT patients and is with about 50% higher than that of the control subjects while in patients with PGT it is quite the reverse, i. e.--glucose tolerance deteriorated parallelly with the reducing of insulin response to glucose stimulus or, in other words--normal glucose tolerance in patients maintained by the increased insulin production. The correlation of blood sugar and insulinemic curves with those of triglyceridemia reveals that with blood sugar elevation and insulinemia during glucose loading--triglyceride level rapidly elevates--i.e. a positive correlation was found among blood sugar, insulinemia and triglyceridemia where triglyceridemia correlates with hyperinsulinemia more intimately than with glycemia. Basing on the data obtained and the general theoretical conditons--the problem of pathogenetic commonness (at least in certain relations) between atherosclerosis, obesity and diabetes mellitus is discussed. A practical conclusion is drawn that the establishment of increased serum triglycerides and hyperinsulinism in pathological and even in still normal carbohydrate tolerance in one subject may play the role of an important diagnostic test, speaking of the possible development or for the presence of already manifested atherosclerosis.