Key result
Intra-arterial insulin increases acetylcholine response equally in non-diabetic CAD patients and healthy controls.
Why the study?
Does intra-arterial insulin infusion alter endothelium-dependent and -independent vasodilation in non-diabetic patients with coronary artery disease compared to healthy controls?
Case-Control (n=40)
Does intra-arterial insulin infusion alter endothelium-dependent and -independent vasodilation in non-diabetic patients with coronary artery disease compared to healthy controls?
Vascular insulin response remains intact in non-diabetic patients with coronary artery disease despite the presence of systemic insulin resistance and baseline endothelial dysfunction.
Answers are grounded in this paper and cite their sources.
Supports intact vascular insulin sensitivity in non-diabetic CAD; leaves open whether systemic resistance modulates coronary endothelial function in vivo.
BACKGROUND: Patients with coronary artery disease (CAD) are often insulin resistant, a state that predisposes to increased atherosclerosis. Recently, it was suggested that a "vascular insulin resistance" could explain this association, causing endothelial dysfunction and hence atherosclerosis. We therefore studied the vascular insulin response in patients with CAD. MATERIALS AND METHODS: Nine non-diabetic patients with documented CAD and 31 lean healthy controls were examined. Forearm blood flow was measured by venous occlusion plethysmography. Dose-response studies of acetylcholine (ACh) and sodium nitroprusside (SNP) elicited endothelium-dependent and -independent vasodilation and were repeated during intra-arterial insulin infusion. RESULTS: Patients were insulin resistant as determined by HOMA index. Insulin infusion resulted in high physiological levels of insulin in the forearm without systemic effects. Patients had a reduced ACh response but insulin infusion increased the ACh response equally in patients and controls (a mean increase of 74+/-37 vs 57+/-24%, patients vs controls, p=0.12). A minor increase of the SNP response was also noted during insulin infusion. CONCLUSION: Vascular insulin response is intact in non-diabetic CAD patients in spite of insulin resistance and endothelial dysfunction.
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Ihlemann et al. (2004) conducted a case-control in Coronary artery disease (n=40). Intra-arterial insulin infusion vs. Lean healthy controls was evaluated on Increase in acetylcholine (ACh) response during insulin infusion (p=0.12). Intra-arterial insulin infusion increased the acetylcholine response equally in non-diabetic CAD patients and healthy controls (mean increase 74% vs 57%, p=0.12).
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