CORRELATION BETWEEN INSULIN RESISTANCE AND SEVERITY OF CORONARY ARTERY DISEASE IN NON-DIABETES
DOI:
https://doi.org/10.22159/ajpcr.2016.v9i6.14637Abstract
Objective: There is an increased risk of CAD in both diabetes and non-diabetes. Insulin resistance has been associated with development of CAD in this both populations. However, there are not many studies on correlation between insulin resistance and severity of CAD in non-diabetes. The present study aimed to establish a correlation between insulin resistance and severity of CAD in non-diabetic individuals.
Methods: A cross-sectional study of 79 consecutive Non-diabetic patients undergoing coronary angiogram for evaluation of clinically suspected coronary artery disease at a tertiary care hospital in Mangalore, Karnataka were recruited. Clinical history, anthropometric and biochemical parameters were analyzed. Insulin resistance was determined by Homeostasis model assessment (HOMA-IR). The severity of CAD was assessed by modified Gensini score. Pearson correlation was done to find out the relation between HOMA-IR and Gensini core.
Results: The correlation between log of HOMA-IR and severity of coronary artery disease as assessed by Gensini score (r = -0.053 and p= 0.64) was not significant in non-diabetic patients. The correlations between severity of coronary artery disease and other known risk factors of coronary artery disease were also was not significant.
Conclusion: HOMA-IR is negatively associated with severity of CAD in non-diabetes.
Downloads
References
REFERENCES
WHO. The Global Burden of Disease: 2004 Update. Geneva: World
Health Organization; 2008b.
WHO. World Health Statistics 2009. Geneva: World Health
Organization; 2009e.
Lozano R, Naghavi M, Foreman K, Lim S, Shibuya K, Aboyans V,
et al. Global and regional mortality from 235 causes of death for 20 age
groups in 1990 and 2010: A systematic analysis for the Global Burden
of Disease Study 2010. Lancet 2012;380(9859):2095-128.
Mathers CD, Loncar D. Projections of global mortality and burden of
disease from 2002 to 2030. PLoS Med 2006;3(11):e442.
Mohan V, Deepa R, Rani SS, Premalatha G. Prevalence of coronary
artery disease and its relationship to lipids in a selected population in
South India: The Chennai Urban Population Study (CUPS No. 5). J Am
Coll Cardiol 2001;38(3):682-7.
Yusuf S, Reddy S, Ounpuu S, Anand S. Global burden of cardiovascular
diseases: PartI: General considerations, the epidemiologic transition, risk
factors, and impact of urbanization. Circulation 2001;104(22):2746-53.
Reaven GM. A syndrome of resistance to insulin stimulated uptake
(syndrome X). Definitions and implications. Cardiovasc Risk Factors
;3:2-11.
Bonora E, Kiechl S, Willeit J, Oberhollenzer F, Egger G, Meigs JB,
et al. Insulin resistance as estimated by homeostasis model assessment
predicts incident symptomatic cardiovascular disease in caucasian
subjects from the general population: The Bruneck study. Diabetes Care
;30(2):318-24.
Kim J, Chae YK, Chernoff A. The risk for coronary heart disease
according to insulin resistance with and without Type 2 diabetes.
Endocr Res 2013;38(4):195-205.
Després JP, Lamarche B, Mauriège P, Cantin B, Dagenais GR,
Moorjani S, et al. Hyperinsulinemia as an independent risk factor for
ischemic heart disease. N Engl J Med 1996;334(15):952-7.
Srinivasan MP, Kamath PK, Manjrekar PA, Unnikrishnan B, Ullal A,
Kotekar MF, et al. Correlation of severity of coronary artery disease
with insulin resistance. N Am J Med Sci 2013;5(10):611-4.
Wallace TM, Levy JC, Matthews DR. Use and abuse of HOMA
modeling. Diabetes Care 2004;27(6):1487-95.
Kim JY, Mun HS, Lee BK, Yoon SB, Choi EY, Min PK, et al. Impact
of metabolic syndrome and its individual components on the presence
and severity of angiographic coronary artery disease. Yonsei Med J
;51(5):676-82.
American Diabetes Association. Diagnosis and classification of
diabetes mellitus. Diabetes Care 2010;33 Suppl 1:S62-9.
Natali A, Vichi S, Landi P, Severi S, L’Abbate A, Ferrannini E. Coronary
atherosclerosis in Type II diabetes: Angiographic findings and clinical
outcome. Diabetologia 2000;43(5):632-41.
Vishnupriya, R, Ezhilramya J, Meenakshi B. Metformin in the
prevention of metabolic syndrome associated with initiation of
atypical antipsychotic therapy in adolescents and young adults - A
randomized, open labelled, single centered study. Int J Pharm Pharm
Sci 2016;8(4):200-6.
Katsuki A, Sumida Y, Gabazza EC, Murashima S, Furuta M,
Araki-Sasaki R, et al. Homeostasis model assessment is a reliable
indicator of insulin resistance during follow-up of patients with Type 2
diabetes. Diabetes Care 2001;24(2):362-5.
Kwon K, Choi D, Koo BK, Ryu SK. Decreased insulin sensitivity is
associated with the extent of coronary artery disease in patients with
angina. Diabetes Obes Metab 2005;7(5):579-85.
Kruszelnicka O, Surdacki A, Golay A. Differential associations of
angiographic extent and severity of coronary artery disease with
asymmetric dimethyl arginine but not insulin resistance in non-diabetic
men with stable angina: A cross-sectional study. Cardiovasc Diabetol
;12:145.
Vonbank A, Saely CH, Rein P, Beer S, Breuss J, Boehnel C, et al.
Insulin resistance is associated with the metabolic syndrome and
is not directly linked to coronary artery disease. Clin Chim Acta
;412(11-12):1003-7.
Solymoss BC, Marcil M, Chaour M, Gilfix BM, Poitras AM, CampeauL.
Fasting hyperinsulinism, insulin resistance syndrome, and coronary
artery disease in men and women. Am J Cardiol 1995;76(16):1152-6.
Takezako T, Saku K, Zhang B, Shirai K, Arakawa K. Insulin resistance
and angiographical characteristics of coronary atherosclerosis. Jpn Circ
J 1999;63(9):666-73.
Shinozaki K, Suzuki M, Ikebuchi M, Hara Y, Harano Y. Demonstration
of insulin resistance in coronary artery disease documented with
angiography. Diabetes Care 1996;19(1):1-7.
Granér M, Syvänne M, Kahri J, Nieminen MS, Taskinen MR. Insulin
resistance as predictor of the angiographic severity and extent of
coronary artery disease. Ann Med 2007;39(2):137-44.
Zornitzki T, Ayzenberg O, Gandelman G, Vered S, Yaskil E, Faraggi D,
et al. Diabetes, but not the metabolic syndrome, predicts the severity and
extent of coronary artery disease in women. QJM 2007;100(9):575-81.
Aziz A, Wheatcroft S. Insulin resistance in Type 2 diabetes and obesity:
Implications for endothelial function. Expert Rev Cardiovasc Ther
;9(4):403-7.
Ausk KJ, Boyko EJ, Ioannou GN. Insulin resistance predicts mortality in
nondiabetic individuals in the U.S. Diabetes Care 2010;33(6):1179-85.
Gast KB, Tjeerdema N, Stijnen T, Smit JW, Dekkers OM. Insulin
resistance and risk of incident cardiovascular events in adults without
diabetes: Meta-analysis. PLoS One 2012;7(12):e52036.
Kendall DM, Cuddihy RM, Bergenstal RM. Clinical application of
incretin-based therapy: Therapeutic potential, patient selection and
clinical use. Am J Med 2009;122 6 Suppl: S37-50.
Matthews DR, Cull CA, Stratton IM, Holman RR, Turner RC. UKPDS
: Sulphonylurea failure in non-insulin-dependent diabetic patients
over six years. UK Prospective Diabetes Study (UKPDS) Group.
Diabet Med 1998;15(4):297-303.
Kahn SE. The relative contribution of insulin resistance and beta-cell
dysfunction to the pathophysiology of Type 2 diabetes. Diabetologia
;46(1):3-19
Published
How to Cite
Issue
Section
The publication is licensed under CC By and is open access. Copyright is with author and allowed to retain publishing rights without restrictions.
