June 1, 1993American Journal of Epidemiology
High Plasma Insulin Level Associated with Coronary Heart Disease in the Elderly
Why the study?
Is high plasma insulin level associated with an increased prevalence of coronary heart disease in elderly nondiabetic subjects?
Population
1,069 nondiabetic adults aged 65-74 years from a representative population sample in Kuopio, eastern Finland
Comparison
High plasma insulin levels (fasting and 2-hour) vs Lower plasma insulin levels
Design
Cross-sectional
Authors
Discussion
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Implication
Hyperinsulinemia was associated with CHD markers in elderly nondiabetics but largely attenuated after adjustment; leaves open independent role.
Key Points
- To evaluate the relationship between fasting and post-load plasma insulin levels and the prevalence of coronary heart disease in non-diabetic elderly individuals.
- Examined a representative population sample of 1,069 nondiabetic participants (396 men and 673 women) aged 65–74 years in Kuopio, eastern Finland (1986–1988).
- Measured fasting and 2-hour post-load plasma insulin levels across quintile groupings and assessed cardiovascular risk factor clustering using multivariate analyses.
- Previous myocardial infarction was linked to 2-hour insulin quintiles in women (4.1% in quintiles I+II, 4.1% in III+IV, and 11.9% in V; p < 0.01), though not in men.
- Prevalence of ischemic electrocardiographic changes increased across 2-hour insulin quintiles in men (39.8%, 50.6%, 59.5%; p < 0.01) and women (35.9%, 39.0%, 53.0%; p < 0.01).
- Angina pectoris rose across 2-hour insulin quintiles (men: 11.2%, 28.8%, 30.4%, p < 0.001; women: 17.0%, 17.8%, 28.4%, p < 0.05), but most associations weakened after adjusting for high triglycerides, low HDL cholesterol, and hypertension.
Structured PICO
Is high plasma insulin level associated with an increased prevalence of coronary heart disease in elderly nondiabetic subjects?
P
Population
1,069 nondiabetic adults (396 men, 673 women) aged 65-74 years from a representative population sample in Kuopio, eastern Finland
I
Intervention
High plasma insulin levels (fasting and 2-hour)
C
Comparator
Lower plasma insulin levels (analyzed by quintiles)
O
Outcome
Prevalence of coronary heart disease (previous myocardial infarction, ischemic electrocardiographic changes, and angina pectoris)hard clinical
Hyperinsulinemia is associated with an increased prevalence of coronary heart disease in the elderly, likely driven by clustering of other metabolic risk factors.
Cite This Study
Mykkˇnen et al. (1993) studied this question.