Objective To determine insulin resistance in patients with coronary heart disease and explore the relationship between insulin resistance and coronary atherosclerosis, cardiovascular risk factors.
Methods The study population consisted of 506 consecutive patients (376 male and 130 female) who underwent coronary angiography and laboratory measurements for suspected or known coronary heart disease. The severity of coronary atherosclerosis was defined by using Gensini's score system. High specific BA-ELISA assays for true insulin was used. Insulin resistance was assessed by HOMA index. 506 cases were allocated into four groups according to HOMA index. Analysis of variance, kruskal-wallis test and χ2 test was employed to investigate the distribution of the clinical data in four groups according to HOMA index. Spearman's correlation analysis and multivariate stepwise linear regression analysis were employed to explore the relationship between HOMA index and Gensini's score, the cardiovascular risk factors.
Result One-way ANOVA and kruskal-wallis test indicated that age, triglyceride, apolipoprotein A, high density lipoprotein cholesterol, uric acid, BMI and Gensini's score differed among four groups according to HOMA index (p<0.05). Spearman's correlation analysis suggested that HOMA index was positively correlated with triglyceride, apolipoprotein B, uric acid, BMI and Gensini score but HOMA index was negatively correlated with apolipoprotein A and high density lipoprotein cholesterol. Multivariate stepwise linear regression analysis showed that BMI had the independent association with HOMA index (r=0.090, p=0.05).
Conclusion Insulin resistance existed in the patients with coronary heart disease. Insulin resistance was positively correlated with coronary atherosclerosis and was independently correlated with BMI in the patients with coronary heart disease.
- Coronary heart disease
- true insulin
- insulin resistance
- coronary atherosclerosis