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Hyperinsulinemia predicts multiple atherogenic changes in lipoproteins in elderly subjects
L Mykkänen1, J Kuusisto, S M Haffner
1Department of Medicine, University of Kuopio, Finland.
Arteriosclerosis and Thrombosis : a Journal of Vascular Biology
|April 1, 1994
Summary
High fasting insulin levels predict future lipid disorders in older adults. Elevated insulin is linked to increased risk of hypertriglyceridemia and abnormal apolipoprotein levels, suggesting insulin resistance may precede these conditions.
Area of Science:
- Endocrinology
- Cardiovascular Medicine
- Gerontology
Background:
- Hyperinsulinemia and insulin resistance are often linked to dyslipidemia.
- Previous cross-sectional studies could not establish causality.
- The role of insulin in the development of lipid disorders requires prospective investigation.
Purpose of the Study:
- To investigate the prospective relationship between baseline fasting insulin levels and the development of lipid disorders.
- To determine if insulin resistance precedes the onset of specific lipid abnormalities in older adults.
Main Methods:
- A longitudinal study of 881 non-diabetic subjects aged 65-74 years.
- Fasting insulin levels were measured at baseline.
- Incidence of hypertriglyceridemia, high LDL cholesterol, low HDL cholesterol, high apoB, low apoAI, and altered lipid ratios was assessed over 3.5 years.
Main Results:
- Baseline insulin levels were not associated with the development of high LDL cholesterol or low HDL cholesterol.
- Elevated baseline insulin significantly predicted the incidence of hypertriglyceridemia (OR, 1.64).
- Higher insulin levels were associated with increased risk of high apoB (OR, 1.54), low apoAI (OR, 1.72), and unfavorable lipid ratios (ORs 1.99 and 1.93).
Conclusions:
- Fasting insulin level is a significant predictor for the development of hypertriglyceridemia and atherogenic apolipoprotein profiles in older adults.
- These findings support the hypothesis that insulin resistance may be a causal factor in the development of certain lipid disorders.
- Insulin resistance may play a crucial role in the pathogenesis of dyslipidemia, particularly in the elderly population.