Objective: The aim of this study was to investigate relations between insulin resistance, hyperinsulinemia, cardiovascular risk factors and functional changes in platelets including their response to the acetylsalycilic acid (ASA) in young, healthy men.
Design and Method: 79 healthy men aged 18-40 were divided into two separate groups: hyperinsulinemic (HI) and normoinsulinemic and insulin resistant (IR) and insulin sensitive. HOMA-IR, HOMA [beta], cardiovascular risk markers, platelet activity parameters (sP-selectin, thromboxane B2), ADP, ristocetin and arachidonic acid (AA)- induced platelet aggregation, nitric oxide metabolites (ADMA, L-arginine, SDMA), oxidative stress markers (MDA, thiol index) and inflammatory, angiogenic and aggregatory endothelial parameters (sICAM1, sVCAM1, PAI-1, sE-selectin, VEGF) were analized. Pulse wave velocity (PWV) and flow mediated vasodilation (FMD) at the baseline and after L-arginine intravenous infusion was measured. The algorithm was repeated after 4 days of oral 75 mg ASA administration.
Results: Groups were similar within demographics characteristics. In the HI group a prevalence to higher systolic blood pressure was greater than in normoinsulinemic one. In the IR group systolic and the diastolic blood pressure were higher than in insulin sensitive subjects. HI and IR men were characterized by more proatherogenic lipid profile. The IR group had higher levels of P-selectin. IR and HI people had greater TXB2 levels and aggregatory platelet response on AA and ristocetin. The IR group had higher PAI-1 level than insulin sensitive group before ASA administration. IR and HI groups had increased platelet activity, lower plasma fibrynolitic activity and attenuated antiaggregatory activity of ASA. IR and HI people were characterized by greater thiol index after ASA administration.
Conclusions: In the group of potentially healthy, young male there is a prevalence of initiating metabolic disturbances, involving insulin excretion, sensitivity and atherogenic dyslipidemia, which predispose to hypertension. Prehypertension and prediabetes in young men require improvement in health programs to target earlier stages of cardiovascular diseases.
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