Relationship between hyperinsulinemia and angiographically defined coronary atherosclerosis in non-diabetic men.

Background: Our aim was to estimate the relationship between hyperinsulinemia and angiographically validated coronary atherosclerosis.

Methods: 102 consecutive non-diabetic male subjects (age 48.9 +/- 9.6 years) with a body mass index 25.9 +/- 2.8 kg/m(2) referred to coronary angiography in our centre were studied. A 75-g oral glucose tolerance test (OGTT) was performed and the areas under the curve (AUC) of serum insulin and glucose were calculated.

Results: Discriminant analysis with stepwise forward variable selection revealed that in younger patients (<50 years), the following parameters affected positively the number of significant coronary lumen reductions: age (F=8.5, p=0.005), lnAUCinsulin (F=5.8, p=0.02), low HDL cholesterol (F=4.4, p=0.04), the smoking habit (F=4.1, p=0.05). In those >=50 years of age, exclusively age (F=5.8, p=0.02) and hyperuricemia (F=3.8, p=0.06) entered the final model.

Conclusion: Our results indicate that in non-diabetic male subjects the association of hyperinsulinemia with the severity of coronary atherosclerosis is only seen in younger patients.