Relationship Between Insulin Resistance And Coronary Artery Disease In Patients Complicated With Normal Glucose Tolerance

Objective:To investigate the relationship between insulin resistance and coronary artery disease in patients complicated with normal glucose tolerance.Materials and methods:One hundred and fifty-two consecutive patients with normal glucose tolerance presented at Zhejang Hospital were enrolled in present study. They were divided into two groups according to homeostatic model assessment2".insulin resistant group (IR, n=61) and insulin sensitive group (IS, n=91).Total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), homocysteine (HCY) and uric acid (UA) were measured for each patient by auto biochemistry analyzer. Selective coronary angiography and Gensini score were performed for all patients. Independent-Samples T test and Mann-Whitney U test were used in measurement data analysis. Chi-square test were used in enumeration data analysis.Spearman’s partial correlation and multiple regression analysis were used in data analysis.Results:The coronary artery lesions observed in the IR group were more severe than those in the IS group. The percentages of normal and one-vessel disease in IR group were significantly lower than those in IS group (9.8%vs30.8%,14.8%vs29.7%, respectively, both P<0.05), while the percentage of multi-vessel disease(50.8%vs12.1%, P<0.01),the amount of coronary artery with stenosis (2.31±1.19vs1.36±1.11,P<0.01)and Gensini score(32.2±34.3vs9.0±1.1, P<0.01) were significantly higher. Partial correlation analysis showed that the amount of coronary artery with stenosis and Gensini score correlated significantly and negatively with insulin sensitivity index (ISI)(ri=-0.390,r2=-0.292,respectively, both P<0.05) after adjusting for influential factors. Multivariate linear regression analysis indicated that ISI was independent factor for the amount of coronary artery with stenosis and Gensini score.Conclusion:Insulin resistance is closely correlated with the severity of coronary artery lesions and is an independent risk factor for coronary artery disease in patients complicated with normal glucose tolerance.