Association of serum apolipoprotein A-I (but not high-density lipoprotein cholesterol) with healed myocardial infarction in men independent of serum insulin and C-peptide

• Published in: The American journal of cardiology Vol. 88; no. 7; pp. 723 - 726
• Main Authors: von Eckardstein, Arnold, Fischer, Frank, Schulte, Helmut, Tataru, Mira-Christine, Köhler, Ekkehart, Assmann, Gerd
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.10.2001; Elsevier; Elsevier Limited
• Subjects: Adult; Apolipoprotein A-I - blood; Biological and medical sciences; C-Peptide - blood; Cardiology. Vascular system; Cardiovascular disease; Case-Control Studies; Cholesterol; Cholesterol, HDL - blood; Coronary Disease - blood; Coronary heart disease; Heart; Heart attacks; Humans; Insulin; Insulin - blood; Male; Medical sciences; Middle Aged; Myocardial Infarction - blood; Peptides; Regression Analysis; Risk Factors; Human; Peptides; Infarct; Pathophysiology; Apolipoprotein AI; Cardiovascular disease; Exploration; Myocardial disease; Coronary heart disease; Insulin; C-Peptide; Cholesterol HDL; Risk factor; Myocardium
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/S0002-9149(01)01840-9

Low serum levels of high-density lipoprotein (HDL) cholesterol or apolipoprotein A-I and high serum levels of insulin increase the risk of coronary heart disease (CHD) and can indicate insulin resistance. We tested the strength, independence, and interactions of associations between HDL cholesterol (or apolipoprotein A-I), insulin (or C-peptide), glucose, and CHD in 95 male nondiabetic patients with CHD who were <60 years old, in 92 probands from the PROCAM study, and in 61 noncardiologic patients; all subjects were matched by age, body mass index, and smoking habits. Systemic hypertension (odds radio [OR] 2.8, 95% confidence intervals [CI] 1.6 to 4.8), high serum levels of glucose (OR 2.3, 95% CI 1.6 to 4.8), insulin (OR 2.1, 95% CI 1.3 to 3.6), and C-peptide (OR 4.1, 95% CI 2.2 to 7.5) as well as low serum levels of HDL cholesterol (OR 2.0, 95% CI 1.1 to 3.5) or apolipoprotein A-I (OR 3.9, 95% CI 2.1 to 7.1) had significant associations with CHD. At multivariate analysis, systolic blood pressure, glucose, apolipoprotein A-I, and C-peptide, but not HDL cholesterol and insulin, had consistent independent associations with CHD. Thus, the combined measurement of apolipoprotein A-I and C-peptide may improve the identification of nondiabetic patients at increased risk for CHD.