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… of coronary heart disease is associated with a higher incidence of nonalcoholic fatty liver disease
L Zhang, K Pu, Z Chai, JB Dixon - Obesity Research & Clinical Practice, 2007 - Elsevier
... and family history of coronary artery disease, and hypertension ... into the blood;
(3) obesity and its ... circumference suggesting the genetic link between the two ...
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… : Importance of Type 2 Diabetes and Familial Combined Hyperlipidemia in Coronary Artery Disease Risk - all 5 versions »
MC Carr, JD Brunzell - Journal of Clinical Endocrinology & Metabolism, 2004 - Endocrine Soc
... guidelines may underestimate their coronary artery disease (CAD) risk. ... rises with
increasing obesity and sedentary ... Link between abdominal obesity and metabolic ...
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Adipokines: molecular links between obesity and atheroslcerosis - all 5 versions »
DCW Lau, B Dhillon, H Yan, PE Szmitko, S Verma - … Journal of Physiology- Heart and Circulatory Physiology, 2005 - Am Physiological Soc
... Subjects with coronary heart disease have lower adiponectin levels compared with
age ... ADIPOKINES ARE THE MOLECULAR LINK BETWEEN OBESITY AND METABOLIC SYNDROME. ...
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… A Comprehensive Perspective Based on Interactions Between Obesity, Diabetes, and Inflammation - all 5 versions »
P Dandona, A Aljada, A Chaudhuri, P Mohanty, R … - Circulation, 2005 - Am Heart Assoc
... to the incidence of coronary heart disease: results from ... A, Bandyopadhyay A.
Inflammation: the link between insulin resistance, obesity and diabetes. ...
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Insulin Resistance and Coronary Heart Disease - all 3 versions »
M LAAKSO, J KUUSISTO - The Metabolic Syndrome AT The Beginning of The Xxist Century …, 2005 - books.google.com
... 3. Laakso M. Insulin resistance and coronary heart disease. ... Chetrit A, Fuchs F.
Hyperinsulinemia: A link between hypertension, obesity and glucose ...
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Independent effect and population impact of obesity on fatal coronary heart disease in adults - all 3 versions »
DM Mann, J Lee, Y Liao, S Natarajan - Preventive Medicine, 2006 - Elsevier
... understanding of the relationships between obesity, diabetes, and ... SummaryPlus | Full
Text + Links | PDF (72 K ... WB Kannel, Overweight and obesity as determinants ...
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… Left Ventricular Remodeling and Diastolic Dysfunction in Patients Without Coronary Artery Disease - all 3 versions »
BD Powell, MM Redfield, KA Bybee, WK Freeman, CS … - The American Journal of Cardiology, 2006 - Elsevier
... designed to identify any associations between LV function ... Abstract | Full Text +
Links | PDF (482 K) | View ... Role of hypertension, diabetes, obesity, and race ...
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… of Adiponectin and Risk of Type 2 Diabetes Mellitus and Coronary Heart Disease in Apparently Healthy … - all 4 versions »
W Koenig, N Khuseyinova, J Baumert, C Meisinger, H … - Journal of the American College of Cardiology, 2006 - Elsevier
... been associated with future coronary heart disease (CHD) events ... cholesterol
(HDL-C), obesity, hypertension, and ... may represent a link between insulin resistance ...
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Between Serum Resistin Levels and Insulin Resistance, Inflammation, and Coronary Artery Disease - all 4 versions »
R Ohmori, Y Momiyama, R Kato, H Taniguchi, M Ogura … - Journal of the American College of Cardiology, 2005 - Am Coll Cardio Found
... is an adipocytokine that may link obesity with insulin ... the role of resistin in obesity
and insulin ... However, association between resistin and coronary artery ...
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Adiponectin, risk of coronary heart disease and correlations with cardiovascular risk markers - all 3 versions »
D Rothenbacher, H Brenner, W Marz, W Koenig - European Heart Journal, 2005 - Eur Soc Cardiology
... who showed at least one coronary stenosis of ... fold risk for ischaemic heart disease
associated with ... It may therefore represent the link between obesity (or even ...
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J Am Coll Cardiol, 2002; 40:937-943
© 2002 by the American College of Cardiology Foundation
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CLINICAL STUDY: OBESITY, DIABETES, AND HEART DISEASE

Relationship between obesity, insulin resistance, and coronary heart disease risk

Fahim Abbasi, MD*, Byron William Brown, Jr, PhD{dagger}, Cindy Lamendola, MSN, ANP*, Tracey McLaughlin, MD* and Gerald M. Reaven, MD*,*

* Department of Medicine, Stanford, California, USA
{dagger} Department of Health Research and Policy, Stanford University School of Medicine, Stanford, California, USA

Manuscript received August 27, 2001; revised manuscript received March 19, 2002, accepted June 4, 2002.

* Reprint requests and correspondence: Dr. Gerald M. Reaven, Falk CVRC Stanford University School of Medicine, 300 Pasteur Drive, Stanford, California 94305-5406, USA
greaven@cvmed.Stanford.edu

OBJECTIVES: The study goals were to: 1) define the relationship between body mass index (BMI) and insulin resistance in 314 nondiabetic, normotensive, healthy volunteers; and 2) determine the relationship between each of these two variables and coronary heart disease (CHD) risk factors.

BACKGROUND: The importance of obesity as a risk factor for type 2 diabetes and hypertension is well-recognized, but its role as a CHD risk factor in nondiabetic, normotensive individuals is less well established.

METHODS: Insulin resistance was quantified by determining the steady-state plasma glucose (SSPG) concentration during the last 30 min of a 180-min infusion of octreotide, glucose, and insulin. In addition, nine CHD risk factors: age, systolic blood pressure, diastolic blood pressure (DBP), total cholesterol, triglycerides (TG), high-density lipoprotein (HDL) cholesterol and low-density lipoprotein cholesterol concentrations, and glucose and insulin responses to a 75-g oral glucose load were measured in the volunteers.

RESULTS: The BMI and the SSPG concentration were significantly related (r = 0.465, p <> associated with each of the nine risk factors. In multiple regression analysis, SSPG concentration added modest to substantial power to BMI with regard to the prediction of DBP, HDL cholesterol and TG concentrations, and the glucose and insulin responses.

CONCLUSIONS: Obesity and insulin resistance are both powerful predictors of CHD risk, and insulin resistance at any given degree of obesity accentuates the risk of CHD and type 2 diabetes.

Abbreviations and Acronyms
BMI
body mass index
CHD
coronary heart disease
DBP
diastolic blood pressure
EGIR
European Group for the Study of Insulin Resistance
HDL
high-density lipoprotein
LDL
low-density lipoprotein
NHANES
National Health and Nutrition Examination Survey
SBP
systolic blood pressure
SSPG
steady-state plasma glucose
SSPI
steady-state plasma insulin
TG
triglycerides




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J Am Coll Cardiol, 2002; 40:937-943
© 2002 by the American College of Cardiology Foundation
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CLINICAL STUDY: OBESITY, DIABETES, AND HEART DISEASE

Relationship between obesity, insulin resistance, and coronary heart disease risk

Fahim Abbasi, MD*, Byron William Brown, Jr, PhD{dagger}, Cindy Lamendola, MSN, ANP*, Tracey McLaughlin, MD* and Gerald M. Reaven, MD*,*

* Department of Medicine, Stanford, California, USA
{dagger} Department of Health Research and Policy, Stanford University School of Medicine, Stanford, California, USA

Manuscript received August 27, 2001; revised manuscript received March 19, 2002, accepted June 4, 2002.

* Reprint requests and correspondence: Dr. Gerald M. Reaven, Falk CVRC Stanford University School of Medicine, 300 Pasteur Drive, Stanford, California 94305-5406, USA
greaven@cvmed.Stanford.edu

OBJECTIVES: The study goals were to: 1) define the relationship between body mass index (BMI) and insulin resistance in 314 nondiabetic, normotensive, healthy volunteers; and 2) determine the relationship between each of these two variables and coronary heart disease (CHD) risk factors.

BACKGROUND: The importance of obesity as a risk factor for type 2 diabetes and hypertension is well-recognized, but its role as a CHD risk factor in nondiabetic, normotensive individuals is less well established.

METHODS: Insulin resistance was quantified by determining the steady-state plasma glucose (SSPG) concentration during the last 30 min of a 180-min infusion of octreotide, glucose, and insulin. In addition, nine CHD risk factors: age, systolic blood pressure, diastolic blood pressure (DBP), total cholesterol, triglycerides (TG), high-density lipoprotein (HDL) cholesterol and low-density lipoprotein cholesterol concentrations, and glucose and insulin responses to a 75-g oral glucose load were measured in the volunteers.

RESULTS: The BMI and the SSPG concentration were significantly related (r = 0.465, p <> associated with each of the nine risk factors. In multiple regression analysis, SSPG concentration added modest to substantial power to BMI with regard to the prediction of DBP, HDL cholesterol and TG concentrations, and the glucose and insulin responses.

CONCLUSIONS: Obesity and insulin resistance are both powerful predictors of CHD risk, and insulin resistance at any given degree of obesity accentuates the risk of CHD and type 2 diabetes.

Abbreviations and Acronyms
BMI
body mass index
CHD
coronary heart disease
DBP
diastolic blood pressure
EGIR
European Group for the Study of Insulin Resistance
HDL
high-density lipoprotein
LDL
low-density lipoprotein
NHANES
National Health and Nutrition Examination Survey
SBP
systolic blood pressure
SSPG
steady-state plasma glucose
SSPI
steady-state plasma insulin
TG
triglycerides




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