Background/Aim: The evidence showed that in the development of diabetes
mellitus type 2 (DMT2) and coronary heart disease (CHD) significant role is
played by metabolic risk factors: insulin resistance (IR), dyslipidaemia and obesity.
Beside metabolic factors, increase in inflammatory markers such as fibrinogen
and hs-C reactive protein (hsCRP) plays a role in developing CHD. Metabolic
disorders are thought to also be present in patients with impaired glucose
tolerance (IGT) and could contribute to development of CHD in these individuals.
Aim of this study was to investigate the behaviour of metabolic parameters
and chronic inflammation markers in patients with IGT on glucose tolerance
test and associated CHD.
Methods: The trial included 4 groups of 30 subjects: a) IGT with CHD, b) IGT
without CHD, c) CHD without IGT and d) control group without CHD and with
normal glucose tolerance (NGT). Within each group glucoregulation parameters
were measured (fasting glucose and Hb1Ac). Oral glucose tolerance test
(OGTT) with 75 g glucose load was performed and IR parameters calculated
(using HOMA-IR, Matsuda index, Quicki index, HOMA1- %B), lipid profile was
done, waist/hip ratio was measured, as well as fibrinogen and hsCRP. CHD diagnosis
was determined by typical signs of previous myocardial infarction on
ECG, echocardiogram and/or ergometry (Bruce protocol).
Results: Subjects with IGT, but no CHD and those with both IGT and CHD had
statistically significantly higher triglyceride and cholesterol levels and manifest
IR with decreased insulin sensitivity compared to subjects with CHD, but
no IGT and control group. Group with both IGT and CHD was found to have significantly
higher fibrinogen and hsCRP concentrations.
Conclusion: IR and hyperlipidaemia, together with chronic inflammation mediators,
are potential predictors of the development of glucose tolerance disorders;
hence interventional treatment during IGT period or during hyperinsulinaemia
could give patients better opportunity to prevent or postpone onset or
development of diabetes and its complications.
