Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Winkelmann, BR; Boehm, BO; Nauck, M; Kleist, P; März, W; Verho, NK; Ranjith, N; Kneissl, G.
Cigarette smoking is independently associated with markers of endothelial dysfunction and hyperinsulinaemia in nondiabetic individuals with coronary artery disease.
Curr Med Res Opin. 2001; 17(2): 132-141.
Doi: 10.1185/0300799039117049
Web of Science
PubMed
FullText
FullText_MUG
- Co-Autor*innen der Med Uni Graz
- März Winfried
- Altmetrics:
- Dimensions Citations:
- Plum Analytics:
- Scite (citation analytics):
- Abstract:
- BACKGROUND: Oxidative stress and endothelial dysfunction have been introduced as a unifying pathological mechanism for early atherosclerotic disease. They are caused by a variety of stimuli including cigarette smoking (environmental) and type 2 diabetes (disease factor). However, the role of hyperinsulinemia, a marker of insulin resistance, as a risk factor for atherosclerosis remains to be clarified. STUDY OBJECTIVES: To study the relationship of smoking, hyperinsulinaemia and biochemical markers of oxidative stress and endothelial dysfunction, in patients with coronary artery disease. DESIGN: Case-control study of 5-year survivor status in smokers, former smokers and nonsmokers with angiographically documented stable coronary artery disease classified by self-reporting of smoking status together with plasma cotinine measurements. SETTING: Cardiology and cardiac surgery unit of a tertiary care referral centre. PATIENTS AND METHODS: Plasma levels of vitamins C, E and selenium, and the adhesion molecules E-selectin, intercellular adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1) were assessed in 214 patients at baseline together with the glucose and insulin response to an oral glucose challenge. Sixty known or newly diagnosed type 2 diabetic patients (28%) were identified and excluded from further analysis. RESULTS: E-selectin and ICAM-1, serving as markers of endothelial dysfunction, significantly correlated with hyperinsulinaemia (p < 0.05). Circulating immunoreactive insulin was elevated in active smokers and former smokers as compared to non-smokers after an oral glucose load (p < 0.05 for the area under the insulin time curve), despite a similar glucose response. Smoking was associated with a decrease in antioxidant vitamins C (p = 0.02) and E (p = 0.03), and an increase of E-selectin (p < 0.05) and ICAM-1 (p < 0.001). Low baseline ICAM-1 and high vitamin C levels emerged as the most significant multivariate predictors of 5-year survival (p < 0.001). CONCLUSIONS: Hyperinsulinaemia in smokers is linked with markers of endothelial dysfunction. Impaired vascular reactivity can thus be a new possible mechanism linking insulin resistance and smoking.
- Find related publications in this database (using NLM MeSH Indexing)
- Biological Markers - blood
- Blood Glucose - metabolism
- Case-Control Studies - metabolism
- Coronary Angiography - metabolism
- Coronary Arteriosclerosis - blood
- Cotinine - blood
- Diabetes Mellitus, Type 2 - blood
- Endothelium, Vascular - physiopathology
- Female - physiopathology
- Germany - epidemiology
- Glucose Tolerance Test - epidemiology
- Humans - epidemiology
- Hyperinsulinism - blood
- Insulin - blood
- Insulin Resistance - blood
- Male - blood
- Middle Aged - blood
- Oxidative Stress - blood
- Risk Factors - blood
- Smoking - adverse effects
- Survival Rate - adverse effects
- Time Factors - adverse effects
- Find related publications in this database (Keywords)
- cigarette smoking
- endothelial dysfunction
- cell adhesion molecule
- hyperinsulinaemia
- insulin resistance
- coronary artery disease