Relationship of glucose and insulin levels to the risk of myocardial infarction: a case-control study
Hertzel C. Gerstein, MD, MSc, FRCPC*  ,
Prem Pais, MD¶,
Janice Pogue, MA, MSc* and
Salim Yusuf, MBBS, DPh, FRCPC* 
* Preventive Cardiology and Therapeutics Research Program, Hamilton Civic Hospitals Research Centre, Hamilton, Ontario, Canada
Divisions of Endocrinology and Metabolism, McMaster University, Hamilton, Ontario, Canada
Division of Cardiology, McMaster University, Hamilton, Ontario, Canada
¶ Department of Medicine, St. John’s Medical College, Bangalore, India
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Figure 1 Fasting glucose quartiles and the risk of myocardial infarction in all subjects. The odds of a myocardial infarction increase with glucose quartile (A) even after subjects with diabetes are excluded (B), subjects with both diabetes and impaired glucose tolerance are excluded (C) and subjects with diabetes, impaired glucose tolerance and impaired fasting glucose are excluded (D). (D) only includes subjects whose fasting glucose is <6.1 mmol/l (i.e., those with no IFG). The actual odds ratios and 95% confidence intervals are above the bars.
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Figure 2 Distribution of cases and controls according to glucose and insulin levels. The frequency distribution of fasting glucose levels (a) in all cases and controls, and of fasting glucose (b), postprandial glucose (c) and fasting insulin (d) in nondiabetic cases and controls is shown. Values that best discriminated cases from controls were calculated in an ROC analysis (Table 3) and are indicated by the dotted lines.
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