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ABSTRACT
Abnormal coronary flow reserve has been reported in patients with Syndrome X. Recent studies have also reported insulin resistance and subsequent hyperinsulinemia in these patients. It has been suggested that hyperinsulinemia plays a role in microvascular dysfunction. In this study, insulin and C peptide response to oral glucose loading was compared in patients with microvascular angina and coronary artery disease with normal controls. Sixteen patients with Syndrome X, 14 normotensive, nondiabetic patients with coronary artery disease and 9 normal individuals comprised the three study groups. After having basal blood glucose, insulin and C-peptide levels, 75 g. oral glucose solution was given to patients. Blood samples were taken 60, 120 and 180 minutes later Blood total cholesterol, LDL cholesterol, HDL cholesterol and triglycerides levels were also measured. Basal glucose and insulin levels were not different between groups. Insulin response to oral glucose in patients with microvascular angina was not different from the control group. However, increased insulin levels were observed in patients with coronary artery disease. Conclusions; 1) Patients with coronary artery disease may have hyperinsulinemia and insulin resistance, 2) There is not insulin resistance in all patients with Syndrome X, 3) Cardiologic and metabolic Syndrome X are probably different entities.
Abnormal coronary flow reserve has been reported in patients with Syndrome X. Recent studies have also reported insulin resistance and subsequent hyperinsulinemia in these patients. It has been suggested that hyperinsulinemia plays a role in microvascular dysfunction. In this study, insulin and C peptide response to oral glucose loading was compared in patients with microvascular angina and coronary artery disease with normal controls. Sixteen patients with Syndrome X, 14 normotensive, nondiabetic patients with coronary artery disease and 9 normal individuals comprised the three study groups. After having basal blood glucose, insulin and C-peptide levels, 75 g. oral glucose solution was given to patients. Blood samples were taken 60, 120 and 180 minutes later Blood total cholesterol, LDL cholesterol, HDL cholesterol and triglycerides levels were also measured. Basal glucose and insulin levels were not different between groups. Insulin response to oral glucose in patients with microvascular angina was not different from the control group. However, increased insulin levels were observed in patients with coronary artery disease. Conclusions; 1) Patients with coronary artery disease may have hyperinsulinemia and insulin resistance, 2) There is not insulin resistance in all patients with Syndrome X, 3) Cardiologic and metabolic Syndrome X are probably different entities.