Skip to main content
Erschienen in: Diabetologia 7/2004

01.07.2004 | Article

Plasma insulin and cardiovascular mortality in non-diabetic European men and women: a meta-analysis of data from eleven prospective studies

verfasst von: The DECODE Insulin Study Group

Erschienen in: Diabetologia | Ausgabe 7/2004

Einloggen, um Zugang zu erhalten

Abstract

Aims/hypothesis

We examined the association between plasma insulin and cardiovascular mortality in non-diabetic European men and women based on data from eleven prospective studies.

Methods

The study population comprised 6156 men and 5351 women aged 30–89 years. Baseline measurements included oral glucose tolerance test, fasting and 2-h plasma insulin, and conventional risk factors. Cox models were used to calculate hazard ratios (HRs) and their 95% confidence intervals, and overall HRs were assessed by meta-analyses.

Results

During the 8.8-year follow-up, 362 men and 70 women died from cardiovascular disease. The age- and smoking-adjusted overall HR of cardiovascular mortality for the highest vs the lower quartiles of fasting insulin was 1.58 (95% CI: 1.26–1.97) in men and 2.64 (1.54–4.51) in women. Adjusting for other risk factors in addition, the HR was 1.54 (1.16–2.03) in men and 2.66 (1.45–4.90) in women. For 2-h insulin these HRs were 1.28 (0.99–1.66), 1.87 (0.87–4.02), and 0.85 (0.60–1.21), 1.36 (0.53–3.45). The overall HRs for interquartile ranges for fasting and 2-h insulin, with full adjustment, were 1.13 (1.05–1.22) and 1.11 (1.01–1.23) in men, and 1.25 (1.08–1.45) and 1.11 (0.91–1.36) in women.

Conclusions/interpretation

Hyperinsulinaemia, defined by the highest quartile cut-off for fasting insulin, was significantly associated with cardiovascular mortality in both men and women independently of other risk factors. Associations between high 2-h insulin and cardiovascular mortality were weaker and non-significant. Weak positive associations of fasting and 2-h insulin with cardiovascular mortality over interquartile ranges were, however, more similar.
Literatur
1.
Zurück zum Zitat Pyörälä K (1979) Relationship of glucose tolerance and plasma insulin to the incidence of coronary heart disease: results from two population studies in Finland. Diabetes Care 2:131–141CrossRefPubMed Pyörälä K (1979) Relationship of glucose tolerance and plasma insulin to the incidence of coronary heart disease: results from two population studies in Finland. Diabetes Care 2:131–141CrossRefPubMed
2.
Zurück zum Zitat Welborn TA, Wearne K (1979) Coronary heart disease incidence and cardiovascular mortality in Busselton with reference to glucose and insulin concentrations. Diabetes Care 2:154–160CrossRefPubMed Welborn TA, Wearne K (1979) Coronary heart disease incidence and cardiovascular mortality in Busselton with reference to glucose and insulin concentrations. Diabetes Care 2:154–160CrossRefPubMed
3.
Zurück zum Zitat Ducimetiere P, Eschwege E, Papoz L, Richard JL, Claude JR, Rosselin G (1980) Relationship of plasma insulin levels to the incidence of myocardial infarction and coronary heart disease mortality in a middle-aged population. Diabetologia 19:205–210CrossRefPubMed Ducimetiere P, Eschwege E, Papoz L, Richard JL, Claude JR, Rosselin G (1980) Relationship of plasma insulin levels to the incidence of myocardial infarction and coronary heart disease mortality in a middle-aged population. Diabetologia 19:205–210CrossRefPubMed
4.
Zurück zum Zitat Yarnell JW, Sweetnam PM, Marks V, Teale JD, Bolton CH (1994) Insulin in ischaemic heart disease: are associations explained by triglyceride concentrations? The Caerphilly Prospective Study. Br Heart J 71:293–296CrossRefPubMedPubMedCentral Yarnell JW, Sweetnam PM, Marks V, Teale JD, Bolton CH (1994) Insulin in ischaemic heart disease: are associations explained by triglyceride concentrations? The Caerphilly Prospective Study. Br Heart J 71:293–296CrossRefPubMedPubMedCentral
5.
Zurück zum Zitat Møller LF, Jespersen J (1995) Fasting serum insulin levels and coronary heart disease in a Danish cohort: 17-year follow-up. J Cardiovasc Risk 2:235–240CrossRefPubMed Møller LF, Jespersen J (1995) Fasting serum insulin levels and coronary heart disease in a Danish cohort: 17-year follow-up. J Cardiovasc Risk 2:235–240CrossRefPubMed
6.
Zurück zum Zitat Després JP, Lamarche B, Mauriege P et al. (1996) Hyperinsulinemia as an independent risk factor for ischemic heart disease. N Engl J Med 334:952–957CrossRefPubMed Després JP, Lamarche B, Mauriege P et al. (1996) Hyperinsulinemia as an independent risk factor for ischemic heart disease. N Engl J Med 334:952–957CrossRefPubMed
7.
Zurück zum Zitat Perry IJ, Wannamethee SG, Whincup PH, Shaper AG, Walker MK, Alberti KG (1996) Serum insulin and incident coronary heart disease in middle-aged British men. Am J Epidemiol 144:224–234CrossRefPubMed Perry IJ, Wannamethee SG, Whincup PH, Shaper AG, Walker MK, Alberti KG (1996) Serum insulin and incident coronary heart disease in middle-aged British men. Am J Epidemiol 144:224–234CrossRefPubMed
8.
Zurück zum Zitat Folsom AR, Szklo M, Stevens J, Liao F, Smith R, Eckfeldt JH (1997) A prospective study of coronary heart disease in relation to fasting insulin, glucose, and diabetes. The Atherosclerosis Risk in Communities (ARIC) Study. Diabetes Care 20:935–942CrossRefPubMed Folsom AR, Szklo M, Stevens J, Liao F, Smith R, Eckfeldt JH (1997) A prospective study of coronary heart disease in relation to fasting insulin, glucose, and diabetes. The Atherosclerosis Risk in Communities (ARIC) Study. Diabetes Care 20:935–942CrossRefPubMed
9.
Zurück zum Zitat Pyörälä M, Miettinen H, Laakso M, Pyörälä K (1998) Hyperinsulinemia predicts coronary heart disease risk in healthy middle-aged men: The 22-Year Follow-up Results of the Helsinki Policemen Study. Circulation 98:398–404CrossRefPubMed Pyörälä M, Miettinen H, Laakso M, Pyörälä K (1998) Hyperinsulinemia predicts coronary heart disease risk in healthy middle-aged men: The 22-Year Follow-up Results of the Helsinki Policemen Study. Circulation 98:398–404CrossRefPubMed
10.
Zurück zum Zitat Lempiäinen P, Mykkänen L, Pyörälä K, Laakso M, Kuusisto J (1999) Insulin resistance syndrome predicts coronary heart disease events in elderly nondiabetic men. Circulation 100:123–128CrossRefPubMed Lempiäinen P, Mykkänen L, Pyörälä K, Laakso M, Kuusisto J (1999) Insulin resistance syndrome predicts coronary heart disease events in elderly nondiabetic men. Circulation 100:123–128CrossRefPubMed
11.
Zurück zum Zitat Lakka HM, Lakka TA, Tuomilehto J, Sivenius J, Salonen JT (2000) Hyperinsulinemia and the risk of cardiovascular death and acute coronary and cerebrovascular events in men: the Kuopio Ischaemic Heart Disease Risk Factor Study. Arch Intern Med 160:1160–1168CrossRefPubMed Lakka HM, Lakka TA, Tuomilehto J, Sivenius J, Salonen JT (2000) Hyperinsulinemia and the risk of cardiovascular death and acute coronary and cerebrovascular events in men: the Kuopio Ischaemic Heart Disease Risk Factor Study. Arch Intern Med 160:1160–1168CrossRefPubMed
12.
Zurück zum Zitat Hanley AJ, Williams K, Stern MP, Haffner SM (2002) Homeostasis model assessment of insulin resistance in relation to the incidence of cardiovascular disease: the San Antonio Heart Study. Diabetes Care 25:1177–1184CrossRefPubMed Hanley AJ, Williams K, Stern MP, Haffner SM (2002) Homeostasis model assessment of insulin resistance in relation to the incidence of cardiovascular disease: the San Antonio Heart Study. Diabetes Care 25:1177–1184CrossRefPubMed
13.
Zurück zum Zitat Hedblad B, Nilsson P, Engström G, Berglund G, Janzon L (2002) Insulin resistance in non-diabetic subjects is associated with increased incidence of myocardial infarction and death. Diabet Med 19:470–475CrossRefPubMed Hedblad B, Nilsson P, Engström G, Berglund G, Janzon L (2002) Insulin resistance in non-diabetic subjects is associated with increased incidence of myocardial infarction and death. Diabet Med 19:470–475CrossRefPubMed
14.
Zurück zum Zitat Zethelius B, Byberg L, Hales CN, Lithell H, Berne C (2002) Proinsulin is an independent predictor of coronary heart disease: report from a 27-year follow-up study. Circulation 105:2153–2158CrossRefPubMed Zethelius B, Byberg L, Hales CN, Lithell H, Berne C (2002) Proinsulin is an independent predictor of coronary heart disease: report from a 27-year follow-up study. Circulation 105:2153–2158CrossRefPubMed
15.
Zurück zum Zitat Nilsson P, Nilsson JÄ, Hedblad B, Eriksson KF, Berglund G (2003) Hyperinsulinaemia as long-term predictor of death and ischaemic heart disease in nondiabetic men: The Malmö Preventive Project. J Intern Med 253:136–145CrossRefPubMed Nilsson P, Nilsson JÄ, Hedblad B, Eriksson KF, Berglund G (2003) Hyperinsulinaemia as long-term predictor of death and ischaemic heart disease in nondiabetic men: The Malmö Preventive Project. J Intern Med 253:136–145CrossRefPubMed
16.
Zurück zum Zitat Welin L, Bresäter LE, Eriksson H, Hansson PO, Welin C, Rosengren A (2003) Insulin resistance and other risk factors for coronary heart disease in elderly men. The Study of Men Born in 1913 and 1923. Eur J Cardiovasc Prev Rehabil 10:283–288CrossRefPubMed Welin L, Bresäter LE, Eriksson H, Hansson PO, Welin C, Rosengren A (2003) Insulin resistance and other risk factors for coronary heart disease in elderly men. The Study of Men Born in 1913 and 1923. Eur J Cardiovasc Prev Rehabil 10:283–288CrossRefPubMed
17.
Zurück zum Zitat Collins VR, Dowse GK, Zimmet PZ et al. (1993) Serum insulin and ECG abnormalities suggesting coronary heart disease in the populations of Mauritius and Nauru: cross-sectional and longitudinal associations. J Clin Epidemiol 46:1373–1393CrossRefPubMed Collins VR, Dowse GK, Zimmet PZ et al. (1993) Serum insulin and ECG abnormalities suggesting coronary heart disease in the populations of Mauritius and Nauru: cross-sectional and longitudinal associations. J Clin Epidemiol 46:1373–1393CrossRefPubMed
18.
Zurück zum Zitat Orchard TJ, Eichner J, Kuller LH, Becker DJ, McCallum LM, Grandits GA (1994) Insulin as a predictor of coronary heart disease: interaction with apolipoprotein E phenotype. A report from the Multiple Risk Factor Intervention Trial. Ann Epidemiol 4:40–45CrossRefPubMed Orchard TJ, Eichner J, Kuller LH, Becker DJ, McCallum LM, Grandits GA (1994) Insulin as a predictor of coronary heart disease: interaction with apolipoprotein E phenotype. A report from the Multiple Risk Factor Intervention Trial. Ann Epidemiol 4:40–45CrossRefPubMed
19.
Zurück zum Zitat Ferrara A, Barrett-Connor EL, Edelstein SL (1994) Hyperinsulinemia does not increase the risk of fatal cardiovascular disease in elderly men or women without diabetes: the Rancho Bernardo Study, 1984–1991. Am J Epidemiol 140:857–869CrossRefPubMed Ferrara A, Barrett-Connor EL, Edelstein SL (1994) Hyperinsulinemia does not increase the risk of fatal cardiovascular disease in elderly men or women without diabetes: the Rancho Bernardo Study, 1984–1991. Am J Epidemiol 140:857–869CrossRefPubMed
20.
Zurück zum Zitat Lindberg O, Tilvis RS, Strandberg TE et al. (1997) Elevated fasting plasma insulin in a general aged population: an innocent companion of cardiovascular diseases. J Am Geriatr Soc 45:407–412CrossRefPubMed Lindberg O, Tilvis RS, Strandberg TE et al. (1997) Elevated fasting plasma insulin in a general aged population: an innocent companion of cardiovascular diseases. J Am Geriatr Soc 45:407–412CrossRefPubMed
21.
Zurück zum Zitat Lindahl B, Dinesen B, Eliasson M et al. (1999) High proinsulin concentration precedes acute myocardial infarction in a nondiabetic population. Metabolism 48:1197–1202CrossRefPubMed Lindahl B, Dinesen B, Eliasson M et al. (1999) High proinsulin concentration precedes acute myocardial infarction in a nondiabetic population. Metabolism 48:1197–1202CrossRefPubMed
22.
Zurück zum Zitat DeFronzo RA, Jacot E, Jequier E, Maeder E, Wahren J, Felber JP (1981) The effect of insulin on the disposal of intravenous glucose. Results from indirect calorimetry and hepatic and femoral venous catheterization. Diabetes 30:1000–1007CrossRefPubMed DeFronzo RA, Jacot E, Jequier E, Maeder E, Wahren J, Felber JP (1981) The effect of insulin on the disposal of intravenous glucose. Results from indirect calorimetry and hepatic and femoral venous catheterization. Diabetes 30:1000–1007CrossRefPubMed
23.
Zurück zum Zitat Reaven GM (1988) Banting lecture 1988. Role of insulin resistance in human disease. Diabetes 37:1595–1607CrossRefPubMed Reaven GM (1988) Banting lecture 1988. Role of insulin resistance in human disease. Diabetes 37:1595–1607CrossRefPubMed
24.
Zurück zum Zitat Liese AD, Mayer-Davis EJ, Haffner SM (1998) Development of the multiple metabolic syndrome: an epidemiologic perspective. Epidemiol Rev 20:157–172CrossRefPubMed Liese AD, Mayer-Davis EJ, Haffner SM (1998) Development of the multiple metabolic syndrome: an epidemiologic perspective. Epidemiol Rev 20:157–172CrossRefPubMed
25.
Zurück zum Zitat Balkau B, Charles MA (1999) Comment on the provisional report from the WHO consultation. European Group for the Study of Insulin Resistance (EGIR). Diabet Med 16:442–443CrossRefPubMed Balkau B, Charles MA (1999) Comment on the provisional report from the WHO consultation. European Group for the Study of Insulin Resistance (EGIR). Diabet Med 16:442–443CrossRefPubMed
26.
Zurück zum Zitat DECODE Study Group (1998) Will new diagnostic criteria for diabetes mellitus change phenotype of patients with diabetes? Reanalysis of European epidemiological data. DECODE Study Group on behalf of the European Diabetes Epidemiology Study Group. BMJ 317:371–375CrossRef DECODE Study Group (1998) Will new diagnostic criteria for diabetes mellitus change phenotype of patients with diabetes? Reanalysis of European epidemiological data. DECODE Study Group on behalf of the European Diabetes Epidemiology Study Group. BMJ 317:371–375CrossRef
27.
Zurück zum Zitat DECODE Study Group (1999) Is fasting glucose sufficient to define diabetes? Epidemiological data from 20 European studies. The DECODE-study group. European Diabetes Epidemiology Group. Diabetes Epidemiology: Collaborative analysis of Diagnostic Criteria in Europe. Diabetologia 42:647–654CrossRef DECODE Study Group (1999) Is fasting glucose sufficient to define diabetes? Epidemiological data from 20 European studies. The DECODE-study group. European Diabetes Epidemiology Group. Diabetes Epidemiology: Collaborative analysis of Diagnostic Criteria in Europe. Diabetologia 42:647–654CrossRef
28.
Zurück zum Zitat DECODE Study Group (1999) Glucose tolerance and mortality: comparison of WHO and American Diabetes Association diagnostic criteria. The DECODE study group. European Diabetes Epidemiology Group. Diabetes Epidemiology: Collaborative analysis Of Diagnostic criteria in Europe. Lancet 354:617–621CrossRef DECODE Study Group (1999) Glucose tolerance and mortality: comparison of WHO and American Diabetes Association diagnostic criteria. The DECODE study group. European Diabetes Epidemiology Group. Diabetes Epidemiology: Collaborative analysis Of Diagnostic criteria in Europe. Lancet 354:617–621CrossRef
29.
Zurück zum Zitat DECODE Study Group (2001) Glucose tolerance and cardiovascular mortality: comparison of fasting and 2-hour diagnostic criteria. Arch Intern Med 161:397–405CrossRef DECODE Study Group (2001) Glucose tolerance and cardiovascular mortality: comparison of fasting and 2-hour diagnostic criteria. Arch Intern Med 161:397–405CrossRef
30.
Zurück zum Zitat DECODE Study Group (2003) Gender difference in all-cause and cardiovascular mortality related to hyperglycaemia and newly-diagnosed diabetes. Diabetologia 46:608–617CrossRef DECODE Study Group (2003) Gender difference in all-cause and cardiovascular mortality related to hyperglycaemia and newly-diagnosed diabetes. Diabetologia 46:608–617CrossRef
31.
Zurück zum Zitat Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC (1985) Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 28:412–419CrossRefPubMed Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC (1985) Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 28:412–419CrossRefPubMed
32.
Zurück zum Zitat World Health Organization (1999) Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus. Report of a WHO Consultation, WHO, Geneva World Health Organization (1999) Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus. Report of a WHO Consultation, WHO, Geneva
33.
34.
Zurück zum Zitat Ruige JB, Assendelft WJ, Dekker JM, Kostense PJ, Heine RJ, Bouter LM (1998) Insulin and risk of cardiovascular disease: a meta-analysis. Circulation 97:996–1001CrossRefPubMed Ruige JB, Assendelft WJ, Dekker JM, Kostense PJ, Heine RJ, Bouter LM (1998) Insulin and risk of cardiovascular disease: a meta-analysis. Circulation 97:996–1001CrossRefPubMed
35.
Zurück zum Zitat Bonora E, Targher G, Alberiche M et al. (2000) Homeostasis model assessment closely mirrors the glucose clamp technique in the assessment of insulin sensitivity: studies in subjects with various degrees of glucose tolerance and insulin sensitivity. Diabetes Care 23:57–63CrossRefPubMed Bonora E, Targher G, Alberiche M et al. (2000) Homeostasis model assessment closely mirrors the glucose clamp technique in the assessment of insulin sensitivity: studies in subjects with various degrees of glucose tolerance and insulin sensitivity. Diabetes Care 23:57–63CrossRefPubMed
36.
Zurück zum Zitat Yeni-Komshian H, Carantoni M, Abbasi F, Reaven GM (2000) Relationship between several surrogate estimates of insulin resistance and quantification of insulin-mediated glucose disposal in 490 healthy nondiabetic volunteers. Diabetes Care 23:171–175CrossRefPubMed Yeni-Komshian H, Carantoni M, Abbasi F, Reaven GM (2000) Relationship between several surrogate estimates of insulin resistance and quantification of insulin-mediated glucose disposal in 490 healthy nondiabetic volunteers. Diabetes Care 23:171–175CrossRefPubMed
37.
Zurück zum Zitat McAuley KA, Williams SM, Mann JI et al. (2001) Diagnosing insulin resistance in the general population. Diabetes Care 24:460–464CrossRefPubMed McAuley KA, Williams SM, Mann JI et al. (2001) Diagnosing insulin resistance in the general population. Diabetes Care 24:460–464CrossRefPubMed
38.
Zurück zum Zitat Yudkin JS, May M, Elwood P, Yarnell JW, Greenwood R, Davey Smith G (2002) Concentrations of proinsulin like molecules predict coronary heart disease risk independently of insulin: prospective data from the Caerphilly Study. Diabetologia 45:327–336CrossRefPubMed Yudkin JS, May M, Elwood P, Yarnell JW, Greenwood R, Davey Smith G (2002) Concentrations of proinsulin like molecules predict coronary heart disease risk independently of insulin: prospective data from the Caerphilly Study. Diabetologia 45:327–336CrossRefPubMed
39.
Zurück zum Zitat Nagi DK, Knowler WC, Mohamed-Ali V, Bennett PH, Yudkin JS (1998) Intact proinsulin, des 31,32 proinsulin, and specific insulin concentrations among nondiabetic and diabetic subjects in populations at varying risk of type 2 diabetes. Diabetes Care 21:127–133CrossRefPubMed Nagi DK, Knowler WC, Mohamed-Ali V, Bennett PH, Yudkin JS (1998) Intact proinsulin, des 31,32 proinsulin, and specific insulin concentrations among nondiabetic and diabetic subjects in populations at varying risk of type 2 diabetes. Diabetes Care 21:127–133CrossRefPubMed
40.
Zurück zum Zitat MacMahon S, Peto R, Cutler J et al. (1990) Blood pressure, stroke, and coronary heart disease. Part 1, Prolonged differences in blood pressure: prospective observational studies corrected for the regression dilution bias. Lancet 335:765–774CrossRefPubMed MacMahon S, Peto R, Cutler J et al. (1990) Blood pressure, stroke, and coronary heart disease. Part 1, Prolonged differences in blood pressure: prospective observational studies corrected for the regression dilution bias. Lancet 335:765–774CrossRefPubMed
41.
Zurück zum Zitat Clarke R, Shipley M, Lewington S et al. (1999) Underestimation of risk associations due to regression dilution in long-term follow-up of prospective studies. Am J Epidemiol 150:341–353CrossRefPubMed Clarke R, Shipley M, Lewington S et al. (1999) Underestimation of risk associations due to regression dilution in long-term follow-up of prospective studies. Am J Epidemiol 150:341–353CrossRefPubMed
42.
Zurück zum Zitat Mooy JM, Grootenhuis PA, de Vries H et al. (1996) Intra-individual variation of glucose, specific insulin and proinsulin concentrations measured by two oral glucose tolerance tests in a general Caucasian population: the Hoorn Study. Diabetologia 39:298–305CrossRefPubMed Mooy JM, Grootenhuis PA, de Vries H et al. (1996) Intra-individual variation of glucose, specific insulin and proinsulin concentrations measured by two oral glucose tolerance tests in a general Caucasian population: the Hoorn Study. Diabetologia 39:298–305CrossRefPubMed
43.
Zurück zum Zitat Juhan-Vague I, Alessi MC (1997) PAI-1, obesity, insulin resistance and risk of cardiovascular events. Thromb Haemost 78:656–660PubMed Juhan-Vague I, Alessi MC (1997) PAI-1, obesity, insulin resistance and risk of cardiovascular events. Thromb Haemost 78:656–660PubMed
44.
Zurück zum Zitat Festa A, D’Agostino R Jr, Howard G, Mykkänen L, Tracy RP, Haffner SM (2000) Chronic subclinical inflammation as part of the insulin resistance syndrome: the Insulin Resistance Atherosclerosis Study (IRAS). Circulation 102:42–47CrossRefPubMed Festa A, D’Agostino R Jr, Howard G, Mykkänen L, Tracy RP, Haffner SM (2000) Chronic subclinical inflammation as part of the insulin resistance syndrome: the Insulin Resistance Atherosclerosis Study (IRAS). Circulation 102:42–47CrossRefPubMed
45.
46.
Zurück zum Zitat Sato Y, Shiraishi S, Oshida Y, Ishiguro T, Sakamoto N (1989) Experimental atherosclerosis-like lesions induced by hyperinsulinism in Wistar rats. Diabetes 38:91–96CrossRefPubMed Sato Y, Shiraishi S, Oshida Y, Ishiguro T, Sakamoto N (1989) Experimental atherosclerosis-like lesions induced by hyperinsulinism in Wistar rats. Diabetes 38:91–96CrossRefPubMed
47.
Zurück zum Zitat Nordestgaard BG, Agerholm-Larsen B, Stender S (1997) Effect of exogenous hyperinsulinaemia on atherogenesis in cholesterol-fed rabbits. Diabetologia 40:512–520CrossRefPubMed Nordestgaard BG, Agerholm-Larsen B, Stender S (1997) Effect of exogenous hyperinsulinaemia on atherogenesis in cholesterol-fed rabbits. Diabetologia 40:512–520CrossRefPubMed
48.
Zurück zum Zitat Knatterud GL, Klimt CR, Levin ME, Jacobson ME, Goldner MG (1978) Effects of hypoglycemic agents on vascular complications in patients with adult-onset diabetes. VII. Mortality and selected nonfatal events with insulin treatment. JAMA 240:37–42CrossRefPubMed Knatterud GL, Klimt CR, Levin ME, Jacobson ME, Goldner MG (1978) Effects of hypoglycemic agents on vascular complications in patients with adult-onset diabetes. VII. Mortality and selected nonfatal events with insulin treatment. JAMA 240:37–42CrossRefPubMed
49.
Zurück zum Zitat UK Prospective Diabetes Study Group (1998) Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). UK Prospective Diabetes Study (UKPDS) Group. Lancet 352:837–853CrossRef UK Prospective Diabetes Study Group (1998) Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). UK Prospective Diabetes Study (UKPDS) Group. Lancet 352:837–853CrossRef
50.
Zurück zum Zitat Laakso M, Sarlund H, Salonen R et al. (1991) Asymptomatic atherosclerosis and insulin resistance. Arterioscler Thromb 11:1068–1076CrossRefPubMed Laakso M, Sarlund H, Salonen R et al. (1991) Asymptomatic atherosclerosis and insulin resistance. Arterioscler Thromb 11:1068–1076CrossRefPubMed
51.
Zurück zum Zitat Agewall S, Fagerberg B, Attvall S, Wendelhag I, Urbanavicius V, Wikstrand J (1995) Carotid artery wall intima-media thickness is associated with insulin-mediated glucose disposal in men at high and low coronary risk. Stroke 26:956–960CrossRefPubMed Agewall S, Fagerberg B, Attvall S, Wendelhag I, Urbanavicius V, Wikstrand J (1995) Carotid artery wall intima-media thickness is associated with insulin-mediated glucose disposal in men at high and low coronary risk. Stroke 26:956–960CrossRefPubMed
52.
Zurück zum Zitat Howard G, O’Leary DH, Zaccaro D et al. (1996) Insulin sensitivity and atherosclerosis. The Insulin Resistance Atherosclerosis Study (IRAS) Investigators. Circulation 93:1809–1817CrossRefPubMed Howard G, O’Leary DH, Zaccaro D et al. (1996) Insulin sensitivity and atherosclerosis. The Insulin Resistance Atherosclerosis Study (IRAS) Investigators. Circulation 93:1809–1817CrossRefPubMed
53.
Zurück zum Zitat Yip J, Facchini FS, Reaven GM (1998) Resistance to insulin-mediated glucose disposal as a predictor of cardiovascular disease. J Clin Endocrinol Metab 83:2773–2776CrossRefPubMed Yip J, Facchini FS, Reaven GM (1998) Resistance to insulin-mediated glucose disposal as a predictor of cardiovascular disease. J Clin Endocrinol Metab 83:2773–2776CrossRefPubMed
54.
Zurück zum Zitat Zethelius B (2002) Proinsulin and insulin sensitivity as predictors of type 2 diabetes mellitus and coronary heart disease—clinical and epidemiological studies with up to 27 years of follow-up. Doctoral thesis, Uppsala University, Sweden Zethelius B (2002) Proinsulin and insulin sensitivity as predictors of type 2 diabetes mellitus and coronary heart disease—clinical and epidemiological studies with up to 27 years of follow-up. Doctoral thesis, Uppsala University, Sweden
55.
Zurück zum Zitat Egger M, Davey Smith G, Schneider M (2001) Systematic reviews of observational studies. In: Egger M, Davey Smith G, Altman DG (eds) Systematic reviews in health care. Meta-analysis in context. BMJ Books, London, pp 211–227 Egger M, Davey Smith G, Schneider M (2001) Systematic reviews of observational studies. In: Egger M, Davey Smith G, Altman DG (eds) Systematic reviews in health care. Meta-analysis in context. BMJ Books, London, pp 211–227
56.
Zurück zum Zitat Laakso M (1993) How good a marker is insulin level for insulin resistance? Am J Epidemiol 137:959–965CrossRefPubMed Laakso M (1993) How good a marker is insulin level for insulin resistance? Am J Epidemiol 137:959–965CrossRefPubMed
57.
Zurück zum Zitat Mykkänen L, Haffner SM, Rönnemaa T, Bergman RN, Laakso M (1997) Low insulin sensitivity is associated with clustering of cardiovascular disease risk factors. Am J Epidemiol 146:315–321CrossRefPubMed Mykkänen L, Haffner SM, Rönnemaa T, Bergman RN, Laakso M (1997) Low insulin sensitivity is associated with clustering of cardiovascular disease risk factors. Am J Epidemiol 146:315–321CrossRefPubMed
58.
Zurück zum Zitat Pyörälä M, Miettinen H, Laakso M, Pyörälä K (2000) Plasma insulin and all-cause, cardiovascular, and noncardiovascular mortality: the 22-year follow-up results of the Helsinki Policemen Study. Diabetes Care 23:1097–1102CrossRefPubMed Pyörälä M, Miettinen H, Laakso M, Pyörälä K (2000) Plasma insulin and all-cause, cardiovascular, and noncardiovascular mortality: the 22-year follow-up results of the Helsinki Policemen Study. Diabetes Care 23:1097–1102CrossRefPubMed
59.
Zurück zum Zitat DECODE Study Group (2004) Prevalence of the metabolic syndrome and its relation to all-cause and cardiovascular mortality in nondiabetic European men and women. Arch Intern Med 164:1066–1076CrossRef DECODE Study Group (2004) Prevalence of the metabolic syndrome and its relation to all-cause and cardiovascular mortality in nondiabetic European men and women. Arch Intern Med 164:1066–1076CrossRef
60.
Zurück zum Zitat Robbins DC, Andersen L, Bowsher R et al. (1996) Report of the American Diabetes Association’s Task Force on standardization of the insulin assay. Diabetes 45:242–256CrossRefPubMed Robbins DC, Andersen L, Bowsher R et al. (1996) Report of the American Diabetes Association’s Task Force on standardization of the insulin assay. Diabetes 45:242–256CrossRefPubMed
Metadaten
Titel
Plasma insulin and cardiovascular mortality in non-diabetic European men and women: a meta-analysis of data from eleven prospective studies
verfasst von
The DECODE Insulin Study Group
Publikationsdatum
01.07.2004
Verlag
Springer Berlin Heidelberg
Erschienen in
Diabetologia / Ausgabe 7/2004
Print ISSN: 0012-186X
Elektronische ISSN: 1432-0428
DOI
https://doi.org/10.1007/s00125-004-1433-4

Weitere Artikel der Ausgabe 7/2004

Diabetologia 7/2004 Zur Ausgabe

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Notfall-TEP der Hüfte ist auch bei 90-Jährigen machbar

26.04.2024 Hüft-TEP Nachrichten

Ob bei einer Notfalloperation nach Schenkelhalsfraktur eine Hemiarthroplastik oder eine totale Endoprothese (TEP) eingebaut wird, sollte nicht allein vom Alter der Patientinnen und Patienten abhängen. Auch über 90-Jährige können von der TEP profitieren.

Niedriger diastolischer Blutdruck erhöht Risiko für schwere kardiovaskuläre Komplikationen

25.04.2024 Hypotonie Nachrichten

Wenn unter einer medikamentösen Hochdrucktherapie der diastolische Blutdruck in den Keller geht, steigt das Risiko für schwere kardiovaskuläre Ereignisse: Darauf deutet eine Sekundäranalyse der SPRINT-Studie hin.

Bei schweren Reaktionen auf Insektenstiche empfiehlt sich eine spezifische Immuntherapie

Insektenstiche sind bei Erwachsenen die häufigsten Auslöser einer Anaphylaxie. Einen wirksamen Schutz vor schweren anaphylaktischen Reaktionen bietet die allergenspezifische Immuntherapie. Jedoch kommt sie noch viel zu selten zum Einsatz.

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

25.04.2024 Hypertonie Nachrichten

Beginnen ältere Männer im Pflegeheim eine Antihypertensiva-Therapie, dann ist die Frakturrate in den folgenden 30 Tagen mehr als verdoppelt. Besonders häufig stürzen Demenzkranke und Männer, die erstmals Blutdrucksenker nehmen. Dafür spricht eine Analyse unter US-Veteranen.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.