Relationship of angiographically defined coronary artery disease with insulin sensitivity and secretion in subjects with different glucose tolerance.

BACKGROUND

Most studies pay attention to the relationship between insulin resistance and coronary artery disease (CAD) in patients with abnormal glucose tolerance. But few studies have focused on the role of insulin secretion. The aim of this study was to investigate the association between insulin sensitivity, insulin secretion, and CAD in patients with different glucose metabolic status.

METHODS

316 newly diagnosed patients with different glucose metabolic status (according to the results of oral glucose tolerance test) were included in this study. The homeostasis model assessment of insulin resistance (HOMA(IR)) and Matsuda index were used to estimate insulin sensitivity; the insulin secretion was assessed using the HOMA-β, insulinogenic index, area under the curve - insulin/glucose (AUC-Ins/Glu). CAD was defined as ≥50% of luminal stenosis in at least one major coronary vessel through coronary angiography.

RESULTS

Univariate analysis revealed that HOMA(IR) and Matsuda index were significantly different between the CAD group and the non-CAD group in all patients. Logistic analysis revealed that Matsuda index was an independent risk factor for the presence of CAD in all patients, and HOMA(IR) was an independent risk factor for the presence of CAD in normal glucose tolerance patients. Moreover, in the CAD group compared to the non-CAD group, there was no significant difference in the HOMA-β, insulinogenic index, and AUC-Ins/Glu in all patients.

CONCLUSIONS

Insulin resistance is closely related to the presence of CAD in newly diagnosed patients with different glucose metabolic status. The insulin secretion may not be closely related to the presence of CAD.