Association between postprandial hyperinsulinemia and coronary artery disease among non-diabetic women: a case control study

Background: We planned a case-control study to assess the relation of fasting glucose, fasting insulin, postprandial glucose and postprandial insulin levels with coronary artery disease in nondiabetic women. Methods: Among 968 consecutive nondiabetic women screened, 104 with coronary artery disease (mean age 60, 4±9) made up the study cohort (group I). One-hundred and four age-matched, nondiabetic women without coronary artery disease who had a similar lipid and blood pressure profile (group II), and 52 healthy, age-matched women served as controls (group III, real control group). Demographics, waist circumference, lipids, fasting glucose postprandial glucose, fasting and postprandial insulin levels were compared among the groups. A separate subgroup analysis were performed in patients with metabolic syndrome. Results: No differences were identified in terms of prevalences of risk factors between group I and group II. Women with coronary artery disease had higher postprandial insulin level than the women in group II and group III. In reverse stepwise logistic regression analysis postprandial hyperinsulinemia was found to be the single independent determinant for coronary artery disease for the entire study group as well as for women with metabolic syndrome. Conclusion: Our data demonstrate that postprandial hyperinsulinemia is independently associated with coronary artery disease, irrespective of fasting glucose, postprandial glucose, and fasting insulin levels in nondiabetic women with clusterings of factors of metabolic syndrome.