Lack of association between genetic variation in the β3-adrenergic receptor gene and insulin resistance in patients with coronary heart disease

The beta-adrenergic system plays a critical role in regulating lipolysis and thermogenesis, Recent studies have suggested that a missense Trp6Arg mutation in the beta(3)-adrenergic receptor gene is involved in visceral obesity and insulin resistance. We investigated the effect of this mutation on insulin resistance in patients with angiographically documented coronary heart disease ([CHD] n = 137) and normal subjects (n = 188), plasma glucose and insulin responses to a 75-g oral glucose tolerance test and insulin resistance measured by the insulin suppression test, were determined in 58 (42%) patients with CHD and 121 (64%) controls. The genotype and allele frequency of the beta(3)-adrenergic receptor did not differ between patients with CHD and controls. The blood pressure, body mass index (BMI), waist to hip ratio, fasting plasma glucose, insulin, and lipid, and plasma glucose and insulin responses to the glucose load were relatively similar in subjects with and without the mutation in CHD and normal groups. The degree of insulin sensitivity, ie, the steady-state plasma glucose concentration, was not significantly different between subjects with and without the mutation in the CHD group (11.3 +/- 1.2, n = 11 v 11.9 +/- 0.6 mmol/L, n = 47, P = NS) and central group (8.4 +/- 0.7, n = 30 v 8.2 +/- 0.4 mmol/L, n = 91, P = NS). We conclude that Trp64Arg polymorphism of the beta(3)-adrenergic receptor gene does not likely play a major role in the development of CHD in the Chinese population, In addition, it appears to have no association with the insulin resistance syndrome in either CHD or non-CHD subjects. Copyright (C) 1999 by W.B. Saunders Company.