Hyperinsulinemia,Lipoprotein (a),and Chlamydia pneumoniae Antibodies—Are They Risk Factors or Serologic Predictors for Progression of Coronary Artery Disease?
Restricted accessResearch articleFirst published online October, 2000
Hyperinsulinemia,Lipoprotein (a),and Chlamydia pneumoniae Antibodies—Are They Risk Factors or Serologic Predictors for Progression of Coronary Artery Disease?
The authors studied 134 patients with unstable angina pectoris symptoms and 32 subjects without coronary artery disease (CAD) for the presence of classical risk factors such as hypercholesterolemia, smoking, and family history of CAD. In addition they analyzed plasma insulin levels, lipoprotein (a) (Lp[a]) levels, and antibody titers against Chlamydia pneumoniae. All patients had a heart catheterization. Patients with diabetes mellitus were excluded from the study. Fasting insulin, low-density lipoprotein (LDL) cholesterol and Chlamydia pneumoniae immunoglobulin G (IgG) and IgA antibody titers did not show any difference in CAD from healthy control subjects, whereas Lp(a) was increased and high- density lipoprotein (HDL) decreased in CAD patients. These data indicate that lipoprotein (a), low HDL cholesterol, and smoking, but neither hyperinsulinemia nor elevated Chlamydia pneumoniae titers, are risk factors or predictors for CAD.
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References
1.
Forschungsverbund Dhp: Die Deutsche Herz-Kreislauf-Präventionsstudie, ed. by Huber H.Berlin: Springer Verlag , 1998, pp 161-236.
2.
Pyörälä K., Laakso M., Uusitupa M.: Diabetes and atherosclerosis : An epidemiologic view. Diabetes Metab Rev3:463-524, 1987.
3.
Laakso M., Rönnemaa T., Letho S., et al: Does NIDDM increase the risk for coronary heart disease similarly in both low- and high-risk populations? Diabetologia38:487-493, 1995.
4.
Janka HU, Balletshofer B., Becker A., et al: Das metabolische Syndrom als potenter Risikofaktor für frühzeitigen Tod bei Typ-II-Diabetikern. Diab Stoffw1:2-7, 1992.
5.
Fontbonne A. : Why can high insulin levels indicate a risk for coronary heart disease? Diabetologia37 :953-955, 1994.
6.
Fontbonne A. , Eschwege E., Cambien F., et al: Hypertriglyceridaemia as a risk factor of coronary heart disease mortality in subjects with impaired glucose tolerance or diabetes: Results from the 11-year follow-up of the Paris Prospective Study . Diabetologia32:300-304, 1989.
7.
Fontbonne A. , Charles MA, Thibult N., et al: Hyperinsulinaemia as a predictor of coronary heart disease mortality in a healthy population: The Paris Prospective Study, 15 year follow-up. Diabetologia34 :356-361, 1991.
8.
Despres JP, Lamarche B., Mauriege P., et al: Hyperinsulinemia as an independent risk factor for ischemic heart disease. N Engl J Med334:952-957, 1996.
9.
Esposito G., Blasi F., Allegra L., et al: Demonstration of viable Chlamydia pneumoniae in atherosclerotic plaques of carotid arteries by reverse transcriptase polymerase chain reaction . Ann Vasc Surg13:421-425, 1999.
10.
World Health Organization: Diabetes mellitus: Report of a WHO study group.Geneva, World Health Organization, 1985; Tech Rep Ser. No. 727.
Dangas G., Ambrose JA, D'Agate DJ, et al: Correlation of serum lipoprotein (a) with the angiographic and clinical presentation of coronary artery disease. Am J Cardiol83:583-585, 1999.
13.
Dahlen GH, Srinivasan SR, Stenlund H., et al: The importance of serum lipoprotein (a) as an independent risk factor for premature coronary artery disease in middle-aged black and white women from the United States. J Intern Med244:417-424, 1998.
14.
Schwartzman RA, Cox ID, Poloniecki J., et al: Elevated plasma lipoprotein (a) is associated with coronary artery disease in patients with chronic stable angina pectoris. J Am Coll Cardiol31:1260-1266, 1998.
15.
Stubbs P., Seed M., Lane D., et al: Lipoprotein (a) as a risk predictor for cardiac mortality in patients with acute coronary syndromes. Eur Heart J19:1355-1364, 1998.
16.
Dean JD, Jones CJ, Hutchison SJ, et al: Hyperinsulinaemia and microvascular angina ("syndrome X"). Lancet337:456-457, 1991.
17.
Burchfiel CM , Sharp DS, Curb JD, et al: Hyperinsulinemia and cardiovascular disease in elderly men: The Honolulu Heart Program. Arterioscler Thromb Vasc Biol18:450-457, 1998.
18.
Welin L., Eriksson H., Larsson B., et al: Hyperinsulinaemia is not a major coronary risk factor in elderly men. The study of men born in 1913. Diabetologia35:766-770, 1992.
19.
Maass M., Bartels C., Kruger S., et al: Endovascular presence of Chlamydia pneumoniae DNA is a generalized phenomenon in atherosclerotic vascular disease. Atherosclerosis140:25-30, 1998.
20.
Gurfinkel E. , Bozovich G., Beck E., et al: Treatment with the antibiotic roxithromycin in patients with acute non-Q-wave coronary syndromes. The final report of the ROXIS Study. Eur Heart J20:121-127, 1999.
21.
Thomas M., Wong Y., Thomas D., et al: Relation between direct detection of Chlamydia pneumoniae DNA in human coronary arteries at postmortem examination and histological severity (Stary grading) of associated atherosclerotic plaque. Circulation99:2733-2736, 1999.
22.
Altman R., Rouvier J., Scazziota A., et al: Lack of association between prior infection with Chlamydia pneumoniae and acute or chronic coronary artery disease. Clin Cardiol22:85-90, 1999.
