Endocrine Abstracts

Background: Obesity, particularly abdominal obesity, is associated with resistance to the effects of insulin on peripheral glucose and fatty acid utilization, often leading to type 2 diabetes mellitus. Insulin resistance, the associated hyperinsulinemia and hyperglycemia, and adipocyte cytokines (adipokines) may also lead to vascular endothelial dysfunction, an abnormal lipid profile, hypertension, and vascular inflammation, all of which promote the development of atherosclerotic cardiovascular disease (CVD). The aim of our study was to assess the association of insulin resistance and inflammatory markers with the occurrence and extent of CAD.

Methods: Plasma level of FBS, oral glucose tolerance test (OGTT), insulin, fibrinogen, TG, LDL-C, HDL-C, ESR, C-reactive protein (CRP), magnesium (Mg) and calcium (Ca) were measured. Measurements were made in samples obtained from 44 patients who had metabolic syndrome with coronary arteries diseases (cases), and 45 patients who had metabolic syndrome but without CAD (controls). Cases were patients with 3 of 5 criteria of metabolic syndrome whom had documented CAD (resent or old MI, positive angiography for CAD) and controls were the patients with metabolic syndrome but (same the cases) but with no evidence of ischemic heart disease (IHD) such as normal electrocardiogram, echocardiogram, exercise tolerance test and no sign and symptom of IHD.

Results: After adjustment for factors, high levels of hsCRP and fibrinogen were significantly related to an increased risk of coronary heart disease in cases group (P<0.001). Although the insulin level, ESR and smoking were higher in cases group but these difference were not significant level of HDL in cases group was lower than control group but no significantly.

Conclusion: Elevated levels of inflammatory markers, particularly hsCRP and fibrinogen level indicate an increased risk of coronary heart disease.