Diabetes, hyperglycaemia, hyperinsulinaemia and atherosclerosis: epidemiological data

Area of Science:

• Cardiology
• Endocrinology
• Epidemiology

Background:

• Coronary heart disease (CHD) is associated with risk factors like arterial hypertension, hypercholesterolemia, smoking, and diabetes.
• The specific role of impaired glucose tolerance (IGT) in CHD development requires further clarification.
• Hyperinsulinaemia has been suspected as a contributing factor to CHD.

Purpose of the Study:

• To summarize epidemiological evidence on the role of IGT in CHD.
• To investigate the independent role of hyperinsulinaemia in CHD.
• To identify early markers of carbohydrate metabolism disturbances linked to atherosclerosis.

Main Methods:

• Review and summarization of global epidemiological studies on IGT and CHD.
• Analysis of prospective surveys investigating the independent role of hyperinsulinaemia.
• Examination of data from the Paris Prospective Study, including normoglycaemic, IGT, and diabetic individuals.

Main Results:

• The independent role of hyperinsulinaemia in CHD was demonstrated in prospective surveys.
• Data from the Paris Prospective Study indicated that hyperinsulinaemia may precede clinical manifestations of atherosclerosis.
• Hyperinsulinaemia appears to be a genuine marker of carbohydrate metabolism disturbance.

Conclusions:

• Hyperinsulinaemia is a significant risk factor for coronary heart disease.
• Impaired glucose tolerance, alongside hyperinsulinaemia, contributes to atherosclerosis.
• Hyperinsulinaemia serves as an early indicator of metabolic dysfunction associated with cardiovascular disease.