MB fraction of cumulative creatine kinase correlates with insulin secretion in patients with acute myocardial infarction: Insulin as a possible determinant of myocardial MB creatine kinase

Matsui, Hiroyuki; Hashimoto, Hidekazu; Fukushima, Akihiko; Kanayama, Hitoshi; Mitani, S.; Toki, Yukio; Okumura, Kenji; Itō, Takayuki

doi:10.1016/s0002-8703(96)90046-0

Cited by 6 publications

(5 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We failed to detect the previously reported correlations between insulin concentration and infarct size [4], between catecholamine concentrations and infarct size [2] and between catecholamine concentrations and blood glucose concentration. In the latter two cases, effects of sympathetic neuronal stimulation are still possible, because circulating catecholamines are a poor index of this response.…”

Section: Discussioncontrasting

confidence: 99%

“…In the latter two cases, effects of sympathetic neuronal stimulation are still possible, because circulating catecholamines are a poor index of this response. We could not confirm that infarct size is related to insulin levels (Table 3), as previously claimed [4]. These results with respect to infarct size are to be expected, because it is now known that the myocardial area at risk is the main determinant, and that the principal modifying factor is reperfusion [15,16].…”

Section: Discussioncontrasting

confidence: 68%

“…Paradoxically, it has also been documented that the plasma insulin concentration is high in this circumstance [3], and may be a determinant of infarct size [4]. Early studies of the acute coronary syndromes [5], carried out over 10 years ago, drew conclusions that are still frequently quoted regarding plasma glucose, insulin and stressor hormone concentrations on admission [6].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Circulating stress hormone and insulin concentrations in acute coronary syndromes: identification of insulin resistance on admission

STUBBS¹,

LAYCOCK²,

ALAGHBAND-ZADEH³

et al. 1999

Clinical Science

View full text Add to dashboard Cite

We re-examined, in the context of modern practice, plasma insulin and stress hormone concentrations in patients admitted to hospital with acute coronary syndromes. Venous blood sampling was carried out prior to anti-thrombotic therapy in 148 patients with myocardial infarction (MI); 76 patients with unstable angina (UA) pectoris were also studied, together with 27 patients with non-cardiac chest pain (NCP). There were significant progressive increases in the concentrations of catecholamines, cortisol, glucose and insulin from NCP to UA to MI patients. Hyperglycaemia (glucose >8 mmol/l) was present in over 50% of MI patients. The plasma cortisol and insulin levels were both significantly positively correlated with the glucose concentration on admission. Only the cortisol concentration was correlated with peak cardiac enzyme levels. The glucose and insulin concentrations on admission in 141 MI and UA patients were related to insulin resistance, as judged from subsequent insulin and glucose concentrations measured while fasting and during a glucose tolerance test. The product of admission insulinxglucose (divided by 25; the admission insulin-resistance index, or AIRI) was significantly correlated with indices of insulin resistance, and was significantly higher (approximately double) in the MI group (7. 81+/-0.76) and the UA group (6.88+/-1.19) than in the control NCP group (3.59+/-0.06; Kuskul-Wallis: P=0.0001), implying that the insulin levels in the first two groups were approximately twice as high as is appropriate for the glucose levels. The ethnic origin of 20% of the patients was the Indian subcontinent; admission insulin and glucose levels in this subgroup were higher than in the non-Asians across all the groups with chest pain. Cortisol was the only stress hormone that was raised in proportion to the size of the infarct, and is a likely partial cause of the elevation in blood glucose. The high insulin levels were related to the prevalence of insulin resistance, and this was particularly important in the Asian subgroup presenting with MI and UA. Thus it appears feasible to identify acute coronary syndrome patients who are insulin-resistant at a time (on admission) when alternative early therapeutic strategies can be instituted.

show abstract

Section: Discussioncontrasting

confidence: 99%

Section: Discussioncontrasting

confidence: 68%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Circulating stress hormone and insulin concentrations in acute coronary syndromes: identification of insulin resistance on admission

STUBBS¹,

LAYCOCK²,

ALAGHBAND-ZADEH³

et al. 1999

Clinical Science

View full text Add to dashboard Cite

show abstract

“…While some studies documented a failure of insulin response following acute myocardial infarction, 3,24,25 others reported that plasma insulin is high in this setting. 25,26 Interestingly, insulin values were related to infarct size in MI patients not submitted to reperfusion, 27 whereas this relation was not detectable in patients submitted to thrombolysis. 26 In the era of mechanical reperfusion, Nishio et al 13 identified, by means of HOMA index, two different subgroups among 61 non-diabetic MI patients: the non-insulin resistant group and the insulin resistant (IR) group, which consisted of transient IR, which correlated with stress hormones, and continuous IR, which correlated with leptin (associated with endothelial dysfunction) thus contributing to restenosis after coronary stenting at four-month follow-up.…”

Section: Discussionmentioning

confidence: 99%

Correlates of acute insulin resistance in the early phase of non-diabetic ST-elevation myocardial infarction

Lazzeri

Valente

Chiostri

et al. 2011

Diabetes and Vascular Disease Research

View full text Add to dashboard Cite

The relationship between insulin secretion and acute insulin resistance (as assessed by Homeostatic Model Assessment [HOMA] index) and clinical and biochemical parameters in the early phase of non-diabetic ST-elevation myocardial infarction (STEMI) is so far unexplored. We aimed at assessing this relation in 286 consecutive STEMI patients without previously known diabetes submitted to primary percutaneous coronary intervention (PCI). Insulin resistance (as indicated by HOMA) was detectable in 67.1%. Non-parametric correlation showed that HOMA index was significantly correlated with BMI (r = 0.242; p < 0.0001) and HbA 1c (r = 0.189; p < 0.001). At multivariable backward linear regression analysis, glycaemia was directly related to leukocyte count (p = 0.0003), age (p = 0.0001), creatine kinase isoform MB (CK-MB) (p = 0.00278) and lactate (p < 0.0001). Insulin was directly and significantly related to glycaemia (p = 0.0006), body mass index (BMI) (p = 0.00028) and lactate (p = 0.0096) In the early phase of STEMI without previously known diabetes the acute glucose dysmetabolism is quite complex, comprising increased glucose values and the development of acute insulin resistance. While insulin secretion is strictly related to BMI, apart from glucose levels, increased glucose values can be mainly related to the acute inflammatory response (as indicated to leukocyte count and C-RP), to age and to the degree of myocardial damage (as inferred by CK-MB) KeywordsAcute insulin resistance, acute phase, HOMA index, hyperglycaemia, STEMI role of insulin resistance, evaluated by means of Homeostatic Model Assessment (HOMA) index, in the early phase of acute myocardial infarction. 13,14 In non-diabetic STEMI patients submitted to percutaneous coronary intervention (PCI), we reported that insulin resistance, as assessed by HOMA-index, is quite common and helps in the early risk stratification, since it represents an independent predictor for in-hospital mortality.15 More recently, Garcia et al. 16 observed that hyperinsulism was the most important factor associated with the occurrence of new cardiovascular events at long-term follow-up in Colombian patients with acute myocardial infarction, thus emphasising the prognostic role of insulin resistance even at long term.

show abstract

“…Oral glucose tolerance test (OGTT) is a standard procedure to identify persons at high risk for type-II diabetes [8]. It is a widely utilized method which has been used to evaluate the β-cell function and insulin resistance [9][10][11][12]. OGTT is a practical test to understand the body's ability to metabolize or oxidize glucose.…”

Section: Introductionmentioning

confidence: 99%

Untitled

2018

RJLBPCS

View full text Add to dashboard Cite

ABSTRACT:Aim: The aim of the present study is to evaluate the toxicity and glucose tolerance potential of Ganoderma applanatum in Sprague Dawley rats. Settings and Design: Acute toxicity study: A single dose of extracts -500, 1000 and 2000mg/kg body weight (b.wt.) were provided to animals and observed for a period of 14days. Sub-acute toxicity: 500 and 1000mg/kg b.wt. of extracts were provided alternatively for a period of 28days and after sacrifice, blood and tissue were evaluated for various investigations. OGTT: Oral glucose tolerance test was carried out in normal and hyperglycemic rats. Methods and Material: Acute and sub-acute toxicity study was conducted for a span of 14days and 28days respectively. The animals were examined for behavioral, physical, physiological and biochemical abnormalities. OGTT was conducted in normal and hyperglycemic rats by administrating 2g/kg b.wt. of glucose orally followed by extracts and standard drugs. Serum glucose level in blood was estimated periodically up to 120min. Statistical analysis: Results were analyzed using ANOVA with Tukey-Kramer multiple comparisons test. Results: No mortality observed in toxicity study. The rats appeared to be normal with no variations in cellular morphology, biochemical parameters and behavioral aspects. Oral administration of both extracts at 250mg/kg and 500mg/kg b.wt. significantly improve glucose tolerance by reducing blood glucose level in alloxan induced diabetic (hyperglycemic) rats. Conclusions: Study concludes the nontoxic nature of G. applanatum and potential use in glucose tolerance.

show abstract

MB fraction of cumulative creatine kinase correlates with insulin secretion in patients with acute myocardial infarction: Insulin as a possible determinant of myocardial MB creatine kinase

Cited by 6 publications

References 28 publications

Circulating stress hormone and insulin concentrations in acute coronary syndromes: identification of insulin resistance on admission

Circulating stress hormone and insulin concentrations in acute coronary syndromes: identification of insulin resistance on admission

Correlates of acute insulin resistance in the early phase of non-diabetic ST-elevation myocardial infarction

Untitled

Contact Info

Product

Resources

About