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(Arteriosclerosis, Thrombosis, and Vascular Biology. 2001;21:1346.)
© 2001 American Heart Association, Inc.

Atherosclerosis and Lipoproteins

Cardiovascular Risk Factors Associated With Insulin Resistance Cluster in Families With Early-Onset Coronary Heart Disease

Anu Kareinen^*; Laura Viitanen^*; Pirjo Halonen; Seppo Lehto; Markku Laakso

From the Department of Medicine (A.K.), North Karelia Central Hospital, Joensuu, Finland, and the Department of Medicine (L.V., S.L., M.L.) and the Computing Centre (P.H.), University of Kuopio, Kuopio, Finland.

Correspondence to Markku Laakso, MD, Professor and Chair, Department of Medicine, University of Kuopio, PO Box 1627, 70211 Kuopio, Finland. E-mail markku.laakso{at}kuh.fi

Abstract—— Coronary heart disease (CHD) is a multifactorial disease caused by environmental and genetic factors. CHD clusters in families, but it is not known whether susceptibility to early-onset CHD is associated with the clustering of cardiovascular risk factors. Therefore, we determined the levels of cardiovascular risk factors among siblings with and without severe early-onset CHD drawn from 101 Finnish families. Probands with CHD, compared with their siblings without CHD, had, respectively, higher 2-hour insulin levels (475.7 versus 331.8 pmol/L, P=0.011) and 2-hour insulin areas (796.2 versus 640.4 pmol/L per hour, P=0.031) in an oral glucose tolerance test, lower high density lipoprotein cholesterol levels (1.22 versus 1.42 mmol/L, P=0.001), higher total triglyceride levels (1.91 versus 1.68 mmol/L, P=0.018), higher very low density lipoprotein triglyceride levels (1.25 versus 1.06 mmol/L, P=0.011), and higher fibrinogen levels (3.8 versus 3.4 g/L, P= 0.008). No significant differences were found in cardiovascular risk factors between affected siblings and probands with CHD. Environmental or lifestyle factors did not differ between siblings with or without early-onset CHD. We conclude that cardiovascular risk factors associated with the insulin resistance syndrome (hyperinsulinemia, low high density lipoprotein cholesterol, high total and very low density lipoprotein triglycerides, and high fibrinogen) are likely to contribute indirectly to early-onset CHD.

Key Words: risk factors • coronary disease • insulin resistance