Hyperinsulinemia, Hyperglycemia, and Impaired Hemostasis

Abstract

Elevated levels of fasting insulin are associated with impaired fibrinolysis and hypercoagulability in subjects with normal glucose tolerance. Hyperinsulinemia is associated primarily with impaired fibrinolysis in subjects with glucose intolerance. Excess risk for cardiovascular disease associated with hyperinsulinemia and glucose intolerance may be mediated in part by enhanced potential for acute thrombosis.

Involvement of leptin in the association between percentage of body fat and cardiovascular risk factors

“…Interestingly, HDL-cholesterol was positively correlated with the QUICKI. Our data corroborate previous findings [48] and indicate that insulin resistance may, by itself or as a consequence of increased fat mass, induce endothelial dysfunction and inflammation. Taken together, these results confirm the marked involvement of insulin resistance associated to increased fat mass in the development of CVD.…”

Glycemic index in chronic disease: a review

“…Although the mechanisms need to be elucidated some evidence suggests that hyperglycemia and hyperinsulinemia may lead to impaired fibrinolysis and thrombosis as shown by clinical (Calles-Escandon et al, 1998) and correlational studies (Juhan-Vague et al, 1989;Meigs et al, 2000), thereby increasing the risk of CHD (Gerstein & Yusuf, 1996;Ruige et al, 1998).…”

Fasting but not postprandial (postmeal) glycemia predicts the risk of death in subjects with coronary artery disease

“…Increasing average glycemia levels, as measured via glycated hemoglobin, are associated with an increased risk of myocardial infarction (3). Glycated hemoglobin levels reflect fasting and postchallenge glycemia (4), and both impaired fasting glycemia (IFG) and postchallenge hyperglycemia following an oral glucose tolerance test (OGTT) have been shown to confer a higher risk of cardiovascular (CV) death in nondiabetic individuals (5)(6)(7).…”

“…In addition, postchallenge hyperglycemia in the diabetic range appears to be associated with CV disease risk independent of fasting glucose levels, according to one recent study (4). IFG and impaired glucose tolerance (IGT), measured after an OGTT, appear to result from different pathophysiological mechanisms, which explains why they may not be associated with the same CV risk (4).…”

“…IFG and impaired glucose tolerance (IGT), measured after an OGTT, appear to result from different pathophysiological mechanisms, which explains why they may not be associated with the same CV risk (4). IGT appears to result from peripheral insulin resistance (4)(5)(6)(7)(8), whereas IFG may be a manifestation of defective insulin secretion (9,10).…”