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PP004

THE SIGNIFICANCE OF INSULIN SECRETION AND RESISTANCE ON THE OCCURRENCE OF CHD IN PREDIABETES TYPE 2

Thursday, 6 October, 2011 - 15:32
Board 1

It has been proven that the occurrence of type 2 DM is associated with abnormalities in insulin secretion and the relationship of sensitivity to the development of coronary heart disease (CHD). In type 2 DM have an important role of metabolic risk factors: elevated insulinemia, IR, dyslipidemia, obesity. This risk is already present in patients with prediabetes.

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ObjectivesIt has been proven that the occurrence of type 2 DM is associated with abnormalities in insulin secretion and the relationship of sensitivity to the development of coronary heart disease (CHD). In type 2 DM have an important role of metabolic risk factors: elevated insulinemia, IR, dyslipidemia, obesity. This risk is already present in patients with prediabetes. GoalEvaluation of insulin secretion and resistance in type 2 prediabetes (IGT) and significance levels insulin the occurrence and intensity of CD. Materials & MethodsThere were four groups of participants:1 group- IGT with ICD (impaired glucose tolerance with ischemic heart disease) (n=30), 2 group- IGT without ICD (n=30), 3 group- ICD without IGT (n=30) and 4 group -Healthy (n=30)

In each group we performed 75 gr glucose tolerance test (OGTT), we measured glucose level and insulin level to calculate parameters IR (HOMA index) and insulin secretion (insulin index), lipid status, glycogen regulation, obesity and blood pressure parameters. For statistic analysis we used student T and X2 test, correlation coefficient and uni and multivariant logistic regression analysis.

ResultsFigure 1 - The value of blood glucose during OGTT in anim groups

Figure 2 - The value insulinaemia during OGTT in anim groups

Fasting the largest concentration insulin was in the two groups, while in 30 ' in group 2 and 4 is almost the same increase in concentration serum insulin (6 times higher than the value fasting).In 120'after glucose stimulation in two groups a slight fall of concentration. In one group did not fall but rather to a further increase in concentrations of insulin (as much as 7 times the initial concentrations of glucose). After examining the results concludes with significantly impaired insulin secretion in basal and after stimulation by glucose in subjects with IGT and CHD. And was found that the first phase of the insulin secretion is delayed in people with impaired glucose tolerance and IHD.

Figure 3 - Analysis of value HOMA index groups

Figure 4 - Value analysis insulin index groups

It is noted that in patients with IGT and insulin resistance IHD was most pronounced at the same time the highest level of compensatory hyperinsulinemia and that in patients with IHD, in the absence of IGT was found most the capacity of insulin secretion (insulin index).

Figure 5 - Value fasting glucose in groups

Figure 6 - Valeu HgbA1C in groups

Applying logistic regression analysis, glucose has a significant effect on the expression of IHD in subjects with IGT but there was no correlation HGbA1C and IR in patients in groups.

DiscussionThe results of large studies have shown that people with prediabetic condition, such as IGT have an increased risk of CHD. Subjects with ICD with and without concomitant IGT in this study included the subjects with previous IM with shorter and longer time period and people during the early phase of acute myocardyal infarct. That this may be another reason why the blood glucose is expressed in people with IGT and associated ICD. High glycemia in individuals with IGT and ICD is assumed to contribute to the age of patients whose average age was higher than in other subjects in research, particularly expressed in relation to the healthy control group. Was found significantly higher value of fasting blood glucose HgbA1C and in person where the reduced beta cell function and elevated HOMA index, which is proven the presence IR. This means that in this research fasting blood glucose in the IFG and IGT range with IR could lead to IBS subjects in the first group. ConclusionSignificantly decreased sensitivity of peripheral tissue to insulin and significant IR in patients with IGT with IBS points that IR has an important role in appearance of IBS in pre-diabetes.