The metabolic syndrome in coronary patients with first detected abnormal glucose tolerance

Abstract

A total of 154 coronary patients (men) aged 40-60 years with first detected disorders of carbohydrate metabolism (abnormal glucose tolerance and diabetes mellitus) were examined in order to define the specific features of the metabolic syndrome. The following main signs forming the metabolic syndrome were distinguished. Fat accumulation in visceral depots predominated (according to computer-aided tomography), the degree of total and abdominal obesity being the same. The optimal anthropometric marker of visceral obesity is the sagittal diameter of the trunk. Hyperinsulinemia stimulated by standard glucose loading is more manifest and long. Other probable hormone dys­functions associated with development of the metabolic syndrome are relative insufficiency of somatotropic hormone, manifesting in response to alimentary fat loading, and disordered hydrocortisone metabolism in hypoglycemia and hyperinsulinemia. Dyslipoproteinemias are characterized by the predominance of hypercholesterolemic and combined types, the pattern and degree of postalimentary lipemia being the same. Involvement of coronary vessels are more extensive and pronounced in coronary patients with first detected disorders of carbohydrate metabolism.