Serum Insulin, Carbohydrate, and Lipid Abnormalities in Patients with Premature Coronary Heart Disease

Abstract

A group of 25 young patients with coronary heart disease was studied to determine the presence of serum insulin, lipid, or glucose abnormalities. Known diabetic and obese patients were excluded. Fasting serum lipids were determined, and a glucose tolerance test was performed to obtain glucose, free fatty acids, and serum insulin levels. Twenty-two of the 25 patients had abnormal insulin responses to a glucose load, elevated serum lipid levels, or an impaired glucose tolerance. The most common abnormality was an abnormal insulin response. These findings confirm the frequent presence of elevated serum lipids and abnormal glucose tolerance in patients with premature coronary heart disease. An abnormal insulin response, however, is a metabolic defect which is less well known and may be a significant risk factor. It is possible that elevated lipids and elevated levels of insulin may facilitate the process of atherosclerosis by permitting lipid accumulation to occur in the intima of the arteries.