The tangled web of coronary risk factors
Article Abstract:
Coronary artery disease (CAD) occurs when fatty atherosclerotic plaques form on the inner surface of the coronary arteries; it results in a decrease in the blood supply to the heart. Cholesterol, particularly low-density lipoprotein (LDL) cholesterol, is widely recognized to play an important role in the development of atherosclerotic plaques. It is coming to be realized that subspecies of LDL cholesterol may be especially involved in the formation of plaques. Intermediate-density lipoprotein (IDL) cholesterol, a particularly atherogenic subclass, normally accounts for between 10 and 15 percent of LDL cholesterol. In patients with CAD, IDL is disproportionately elevated, and may play an important causal role in the development of the disease. Several other subclasses, such as LDL-III, may also play important roles in the development of CAD; in the future, it may be more important to know the composition of a patient's LDL cholesterol than the absolute level, at least for risk estimation purposes. Elevated LDL-III levels have been linked to a variety of metabolic and hormonal factors, each of which is known to be a risk for the development of CAD. These factors include male gender, abdominal obesity, postmenopause, elevated blood fat levels, and alterations in several cholesterol-related compounds in the blood. These risk factors are also known to be associated with insulin resistance (the decreased effect of insulin on sugar metabolism) and hyperinsulinemia (elevated levels of insulin in the blood). The large number of risk factors involved in the development of CAD and the complicated interrelationships between them may be responsible for the apparent wide variability in development of CAD in the general population. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Medicine
Subject: Health care industry
ISSN: 0002-9343
Year: 1991
User Contributions:
Comment about this article or add new information about this topic:
Workshop IX - lipids, insulin, diabetes
Article Abstract:
Insulin-dependent diabetes mellitus (IDDM) is a condition in which the insulin-secreting pancreatic beta cell ceases to function properly, resulting in excessively low levels of insulin in the blood. Noninsulin-dependent diabetes mellitus (NIDDM) is a condition characterized by a reduction in the sensitivity of body tissues to the effects of insulin (insulin resistance). Because the primary role of insulin is to promote the metabolism of sugars such as glucose, both conditions result in excessively high levels of blood glucose (hyperglycemia). The study of these two conditions will likely yield insights into the mechanisms of the proposed linkage between hyperglycemia and hyperinsulinemia, disordered lipid (fat) metabolism, and the development of cardiovascular conditions, such as coronary artery disease and high blood pressure (hypertension). Studies have suggested that insulin resistance and hyperinsulinemia are both independent risk factors for the development of cardiovascular diseases. Insulin seems to play an important role in the transformation of the normal arterial wall into fatty atherosclerotic plaque, and insulin resistance-induced hyperglycemia also appears to have detrimental effects on the arterial wall, contributing to the development of vascular defects. Lipids, a class of endogenous substances of which cholesterol is an important member, are closely coupled to the development of cardiovascular diseases. IDDM and NIDDM patients appear to have differential alterations in lipid metabolism, and the comparison of these two groups of patients will, it is hoped, yield insights into the relation between lipids, insulin, and diabetes. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Medicine
Subject: Health care industry
ISSN: 0002-9343
Year: 1991
User Contributions:
Comment about this article or add new information about this topic:
Insulin as a mitogenic factor: role in the pathogenesis of cardiovascular disease
Article Abstract:
Atherosclerosis is a condition in which fatty deposits form on the inner surface of blood vessels, decreasing the amount of blood that can flow through them. When this condition occurs in the coronary arteries, the resulting diminution in cardiac blood flow has numerous complications. Evidence has accumulated during recent years that the pancreatic hormone insulin may play an important role in the development of atherosclerosis. Insulin can stimulate growth of arterial-wall smooth muscle cells, as well as cholesterol synthesis and low-density lipoprotein (the so-called ''bad'' cholesterol) binding to its receptors. In non-insulin-dependent diabetes mellitus (NIDDM), the tissues of the body become resistant to the effects of insulin on sugar metabolism, and both insulin and blood glucose rise to excessively high levels (hyperinsulinemia and hyperglycemia). These high glucose levels may cause injury to or delay healing of the vascular endothelium (the inner lining of blood vessels), allowing insulin to have access to arterial smooth muscle cells, in which it can affect cell division and cholesterol metabolism. These changes may promote the formation of atherosclerotic plaques and may explain, in part, why NIDDM patients are more susceptible to the development of atherosclerosis and its complications (such as cardiovascular disease) than nondiabetics. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Medicine
Subject: Health care industry
ISSN: 0002-9343
Year: 1991
User Contributions:
Comment about this article or add new information about this topic:
- Abstracts: Surgical wound infection. Analysis of risk factors for surgical wound infections following vascular surgery. Risk factors for postoperative infection
- Abstracts: Role of medical screening in the prevention of occupational disease. Suing the doctor: lawsuits by injured workers against the occupational physician
- Abstracts: Role of medical screening in the prevention of occupational disease. part 2 Interpretation and communication of the results of medical field investigations
- Abstracts: A randomized, open-label comparison of nonprescription loperamide and attapulgite in the symptomatic treatment of acute diarrhea
- Abstracts: Rationale for treatment. Management of hypertension and cardiovascular risk. Cigarette smoking, adiposity, non-insulin-dependent diabetes, and coronary heart disease in Japanese-American men