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Query: UMLS:C0018799 (heart disease)
 34,133 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We have shown a close relation between clinical microvascular complications and abnormalities of left ventricular function in 185 established diabetics without clinical heart disease. In 50 insulin-dependent diabetics who presented at under 20 years of age there was a correlation between the duration of diabetes and the isovolumic relaxation time, minimal dimension to mitral valve opening, and ratio of pre-ejection period to left ventricular ejection time. Diabetics with mild microvascular complications were similar to diabetics with no complications except for minor prolongation of the diastolic time intervals. Those with severe complications were significantly different from diabetes with milder complications and normal controls in all variables of left ventricular function. A close relation between left ventricular function and the microvascular complications index (code 0 when no complications to code 7 when all present and severe) was found for the following variables: isovolumic relaxation time, the interval from minimal dimension to mitral valve opening, ratio of pre-ejection period to left ventricular ejection time, and pre-ejection period index. It is concluded that in diabetes abnormalities of left ventricular function are related to duration of disease and complications; and that a diabetic specific heart muscle disorder occurs frequently in patients with severe microvascular complications.
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PMID:Left ventricular function in diabetes mellitus. II: Relation between clinical features and left ventricular function. 700 56

Pima Indians have a high prevalence of hyperinsulinemia, obesity, and diabetes, but they have low plasma cholesterol levels, reduced low density lipoprotein synthesis, and little arteriosclerotic heart disease. To investigate lipoprotein metabolism further in this group, very low density lipoprotein (VLDL) metabolism was studied, using [3H]glycerol as an endogenous precursor of triglyceride (TG) synthesis, in 15 obese Pima nondiabetic males and compared to that of 10 obese and 13 normal weight, normolipidemic, nondiabetic Caucasian males. The resultant kinetic data were analyzed using a multicompartmental model which includes two pathways for VLDL-TG synthesis and a process of stepwise delipidation for VLDL catabolism. As compared to obese Caucasians, the obese Pimas had a lower rate of VLDL-TG synthesis, and a lower proportion of slow pathway for synthesis. The fractional catabolic rate in the Pimas was higher than in either Caucasian group, a larger proportion of VLDL-TG was delipidized at each step, and particle residence time was shorter. When the relation between VLDL-TG metabolism and plasma insulin was examined, plasma insulin levels in the Pima were not correlated with VLDL-TG synthetic rates, catabolic rates, or plasma pools. On the other hand VLDL-TG synthetic rates were correlated with plasma free fatty acid levels. Thus, in this population with low plasma lipids and reduced arteriosclerotic heart disease, VLDL-TG synthesis is low, VLDL-TG catabolism is accelerated, and VLDL pools appear to be insensitive to the influence of body weight and hyperinsulinemia.
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PMID:Studied of very low density lipoprotein triglyceride metabolism in an obese population with low plasma lipids: lack of influence of body weight or plasma insulin. 700 43

A quantitative histologic study of hearts from streptozotocin-diabetic and nondiabetic rats was performed. The diabetic rats comprised as group of poorly controlled and one of well-controlled insulin-treated animals. The relative amount of connective tissue was statistically significantly increased in the poorly controlled diabetic rats (p less than 0.01). In the well-controlled group of diabetic rats, the relative amount of connective tissue was the same as in the controls. The number of cells in tunica media of the larger intramural coronary arteries was statistically significantly increased in the diabetic rats in a poorly controlled state (p less than 0.01). There was no difference between the control group and the diabetic rats in a well-controlled metabolic state. Thrombosis or calcification in tunica media of the large intramural coronary arteries was not observed. The present study is reconcilable with the hypothesis of a diabetic cardiopathy and strongly emphasizes the importance of careful insulin treatment.
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PMID:Experimental diabetic cardiopathy preventable by insulin treatment. 702 21

The venous plasma glucose and insulin concentrations recorded during oral glucose tolerance testing of over 300 1st degree relatives (parents and siblings) of insulin dependent diabetics are presented. Men had higher glucose concentrations than women, the difference increasing with age, while insulin responses appeared greater in adolescent girls and young women than their male counterparts. The possible relationship between the different insulin responses in the two sexes and the sex difference in cardiovascular risk factors is discussed. It is suggested that the absence of a marked sex differential in heart disease mortality amongst diabetics may partly result from the loss by diabetic women of their greater insulin production relative to men in young adult life.
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PMID:Age and sex variations in glucose tolerance and insulin responses: parallels with cardiovascular risk. 703 79

The magnitude and impact of diabetes mellitus as a public health problem on Guam was assessed by retrospective analysis of birth and death certificates, as well as chart review of hospital deaths for complications. Non-insulin-dependent diabetes is common on Guam; insulin-dependent diabetes is rare. Diabetes and diabetes-associated mortality rates were similar to those of the general United States population; however, the age-specific rates in persons aged 45 yr and over were two to three times greater. The mean age of the Guam population is only 18.9 yr, about 10 yr younger than the United States mainland. These circumstances could result in the number of persons aged 45 yr and over increasing disproportionately in the future, increasing dramatically the number of persons at risk to develop non-insulin-dependent diabetes. The population found to have the highest rates for diabetes and related complications was the Chamorros (indigenous Guamanians), who comprise the major population group of the Territory. This population experinced most of the complications associated with diabetes, heart disease and hypertension being important causes of morbidity and mortality on Guam. It is likely that many of the complications of pregnancy associated with diabetes go unrecognized. The cost of diabetes to the Territory was estimated to be at least 3 million dollars per year.
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PMID:Diabetes mellitus as an emerging public health problem on Guam. 738 43

Considerable evidence indicates that obesity, and in particular abdominal obesity, is a risk factor for both heart disease and non-insulin dependent diabetes mellitus. In spite of this, little is known of the regulation of triacylglycerol synthesis in adipose tissue other than by insulin. Acylation stimulating protein (ASP), a human plasma protein, stimulates triacylglycerol synthesis in adipose tissue and is also produced by human adipocytes. ASP may play a physiological role in the regulation of efficiency of adipose tissue fat storage and affect clearance of triglycerides from plasma.
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PMID:The acylation stimulating protein-adipsin system. 755 May 36

The prevalence of peripheral vascular disease (PVD) was assessed in terms of ankle/brachial index by doppler studies in a large cohort of non-insulin-dependent diabetes mellitus (NIDDM) patients in South India. One hundred and ninety-two out of 4941 patients (3.9%) had evidence of PVD. There was a slight female excess in PVD patients. There was a linear increase in prevalence of PVD with increasing duration of diabetes. Multiple logistic regression analyses showed that serum cholesterol, serum creatinine, systolic BP, duration of diabetes and ishaemic heart disease are strong predictive factors for PVD. The prevalence of PVD in South Indians is lower than that reported in European populations.
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PMID:Peripheral vascular disease in non-insulin-dependent diabetes mellitus in south India. 755 7

VLDL1, VLDL2, IDL, and LDL and its subfractions (LDL-I, LDL-II, and LDL-III) were quantified in 304 normolipemic subjects together with postheparin plasma lipase activities, waist/hip ratio, fasting insulin, and glucose. Concentrations of VLDL1 and VLDL2 rose as plasma triglycerides (TGs) increased across the normal range, but the association of plasma TGs with VLDL1 showed a steeper slope than that of VLDL2 (P < .001). Plasma TG level was the most important determination of LDL subfraction distribution. The least dense species, LDL-I, decreased as the level of this plasma lipid rose in the population. LDL-II in both men and women exhibited a positive association with plasma TG level in the range 0.5 to 1.3 mmol/L, increasing from about 100 to 200 mg/dL. In contrast, within this TG range the LDL-III concentration was low (approximately equal to 30 mg/dL) and changed little. As plasma TGs rose from 1.3 to 3.0 mmol/L there was a significant fall in LDL-II concentration in men (r = .45, P < .001) but not in women (r = .1, NS). Conversely, above the TG threshold of 1.3 mmol/L there was a steeper rise in LDL-III concentrations in men than in women (P < .001); 42% of the men had and LDL-III in the range associated with high risk of heart disease ( > 100 mg lipoprotein/dL plasma) compared with only 17% of the women. Other influences on the LDL subfraction profile were the activities of lipases and parameters indicative of the presence of insulin resistance. Men on average had twice the hepatic lipase activity of women. This enzyme was not strongly associated with variation in the LDL subfraction profile in men, but in women it was correlated with LDL-III (r = 39, P = .001) and remained a significant predictor in multivariate analysis. Increased waist/hip ratio, fasting insulin, and glucose were correlated negatively with LDL-I and positively with LDL-III, primarily, at least in the case of LDL-III, through raising plasma TGs. On the basis of these cross-sectional observations we postulate the following model for the generation of LDL-III. Subjects develop elevated levels of large TG-rich VLDL1 for a number of reasons, including failure of insulin action. The increase in the concentration of VLDL1 expands the plasma TG pool, and this, via the action of cholesteryl ester transfer protein (which facilitates neutral lipid exchange between lipoprotein particles), promotes the net transfer of TGs into LDL-II, the major LDL species.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Relations between plasma lipids and postheparin plasma lipases and VLDL and LDL subfraction patterns in normolipemic men and women. 758 63

The goal of the study was to compare cardiovascular heart disease risk factors in women with polycystic ovary syndrome (PCOS) and matched control subjects. Women with PCOS have risk factors, including anovulation, hyperandrogenism, and insulin resistance, that suggest a male coronary heart disease risk-factor profile. A total of 206 women with PCOS were recruited by using records from a large reproductive endocrinology practice. A clinical diagnosis of PCOS was made if there was a history of chronic anovulation in association with either clinical evidence of androgen excess (hirsutism) or if total testosterone level was > 2 nm/L or the luteinizing hormone/follicle-stimulating hormone ratio was greater than 2. The overall response rate for cases was 76%. A control population was obtained by using a combination of area voters' registration tapes and directories of households. A control subject was matched to each case subject by age +/- 5 years, race, and neighborhood. The response rate for recruitment of the first or second eligible control subject was 83.6%. The average age at initial interview was 35.9 +/- 7.4 years for case and 37.2 +/- 7.8 years for control subjects. Women with PCOS had significantly increased cardiovascular disease risk factors compared with control women. These included increases in body mass index, insulin, and triglyceride levels (P < .001), decreased total HDL and HDL2 levels (P < .01), and increased total cholesterol and fasting LDL levels, waist/hip ratio, and systolic blood pressure (P < .05).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Coronary heart disease risk factors in women with polycystic ovary syndrome. 760 Jan 12

Although coronary heart disease (CHD) is currently the leading cause of death among American Indians, information on the prevalence of CHD and its association with known cardiovascular risk factors is limited. The Strong Heart Study was initiated in 1988 to quantify cardiovascular disease and its risk factors among three geographically diverse groups of American Indians. Members of 13 Indian communities in Arizona, Oklahoma, and South and North Dakota between 45 and 74 years of age underwent a physical examination that included medical history; an electrocardiogram; anthropometric and blood pressure measurements; an oral glucose tolerance test; and measurements of fasting plasma lipoproteins, fibrinogen, insulin, hemoglobin A1c, and urinary albumin. Prevalence rates of definite myocardial infarction and definite CHD were higher in men than in women at all three centers (p < 0.0001) and higher in those with diabetes mellitus (p = 0.002 in men and p = 0.0003 in women). Diabetes was associated with relatively higher prevalence rates of myocardial infarction (diabetic:nondiabetic prevalence ratio = 3.8 vs. 1.9) and CHD (prevalence ratio = 4.6 vs. 1.8) in women than in men. Prevalence rates of heart disease were lowest in the communities in Arizona; prevalence rates were similar in Oklahoma and South Dakota/North Dakota and were two- to threefold higher than those in Arizona. By logistic regression, prevalent CHD among American Indians was significantly and independently related to age, diabetes, hypertension, albuminuria, percentage of body fat, smoking, high concentrations of plasma insulin, and low concentrations of high density lipoprotein cholesterol. In contrast to reports from other non-Indian populations, diabetes was the strongest risk factor. The lower prevalence of CHD among Indians in Arizona is distinctive in view of their higher rates of diabetes, obesity, hypertension, and albuminuria, but it may be partly related to their low frequency of smoking and their low concentrations of total and low density lipoprotein cholesterol. These findings from the initial Strong Heart Study examination emphasize the importance of diabetes and its associated variables as risk factors for CHD in Native American populations.
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PMID:Coronary heart disease prevalence and its relation to risk factors in American Indians. The Strong Heart Study. 763 30


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