Key result
Hyperglycemia (fasting glucose and HbA1c) was significantly correlated with reduced coronary flow reserve in normotensive NIDDM patients, whereas insulin resistance was not.
Why the study?
Is reduced coronary flow reserve in normotensive NIDDM related to insulin resistance or hyperglycemia?
Observational
Is reduced coronary flow reserve in normotensive NIDDM related to insulin resistance or hyperglycemia?
In normotensive NIDDM patients, reduced coronary flow reserve is associated with hyperglycemia rather than insulin resistance.
Hyperglycemia correlates with reduced coronary flow reserve in normotensive NIDDM independent of insulin resistance; hypothesis-generating and requires prospective validation.
To clarify if coronary flow reserve (CFR) is related to insulin resistance or hyperglycemia in normotensive NIDDM, myocardial blood flow (MBF) at baseline and during dipyridamole loading were measured with 13N-ammonia positron-emission tomography. CFR was significantly reduced in NIDDM patients compared with age-matched control subjects. CFR in patients with well-controlled NIDDM was significantly higher than in those with poorly controlled NIDDM, whereas insulin resistance was comparable between the two groups. CFR in NIDDM patients was not related to the degree of insulin resistance. CFR correlated significantly with average fasting glucose concentration and average HbA1c, but not with insulin resistance, age, lipid parameters, or blood pressure. In conclusion, control of blood glucose concentration rather than insulin resistance is most likely related to the reduced CFR in NIDDM.
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Yokoyama et al. (1998) conducted an observational in Normotensive non-insulin-dependent diabetes mellitus (NIDDM). Hyperglycemia vs. Well-controlled NIDDM and healthy controls was evaluated on Coronary flow reserve (CFR). Hyperglycemia (fasting glucose and HbA1c) was significantly correlated with reduced coronary flow reserve in normotensive NIDDM patients, whereas insulin resistance was not.
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