Evaluation of metabolic syndrome in elderly age patients of coronary heart disease

BACKGROUND: Recently, metabolic syndrome is increasing in Japan and it is thought to be the cause of coronary heart disease. In this study, we evaluated the metabolic syndrome and insulin resistance that is thought to be located in the upstream of metabolic syndrome in high age patients of coronary heart disease. PATIENTS AND METHODS: Coronary risk factors were examined and OGTT with measurement of plasma glucose and serum insulin was done to evaluate metabolic syndrome and insulin resistance in 214 patients who underwent coronary angiography; 102 patients were over 65 years old (high age group) and another 112 were young age group. We compared the two groups. RESULTS: The rate of hypertension was significantly high and that of obesity, LDL-cholesterol level and triglyceride level were significantly low in high age group compared with the young age group. There was no difference in the ratio of metabolic syndrome between the two groups. The frequency of insulin resistance confirmed by HOMA-R was significantly high in the young age group, however there was no difference confirmed by 2 hour serum insulin level after OGTT. CONCLUSION: The influence of glucose metabolism and insulin resistance was equal between the two groups. The frequency of metabolic syndrome was the same, but the coronary risk factors were different between the two groups. Abnormal glucose metabolism and insulin resistance were common to both groups. To diagnose insulin resistance, 2 hour serum insulin level was more effective than HOMA-R.