Insulin Resistance and severity of coronary artery diseases in Patients with Coronary Artery Diseases

Kim, Dae Jung; Nam, Jae Hyun; Choi, Dong Hoon; Kim, Hyeung Jin; Kim, Soo Kyung; Kim, Se Hwa; Rhee, Yumie; Ahn, Chul Woo; Cha, Bong Soo; Song, Young Duk; Lim, Sung Kil; Kim, Kyeong Rae; Lee, Hyun Chul; Huh, Kap Bum

Abstract

BACKGROUND: Insulin resistance (IR) has been identified as a risk factor of atherosclerosis, which may be induced through a mechanism brought about by hypertension, obesity, glucose intolerance and dyslipidemia. The purpose of this study was to investigate the relationship between coronary artery disease (CAD) and insulin resistance.
METHODS
Of 92 subjects having undergone coronary angiography 70 with significantly stenotic coronary artery were designated as the CAD group, with the other 22, without stenosis, as the control group. The CAD group was subdivided into 3 smaller groups according to the severity of their CAD; these being 1-vessel disease (group 1, n=31), 2-vessel disease (group 2, n=25), and 3-vessel disease (group 3, n=14). RESULTS: Kitt for patients with CAD was significantly lower than in the control group, and also for those in group 1 compared to groups 2 and 3, 2.72+/-1.29, 2.25+/-0.68 and 2.21+/-0.78%/min, with that of the controls being 3.01+/-1.22%/min p<0.05). There were significant differences between the IR group and the non-IR group in the common carotid artery intima-media thickness (1.09mm vs. 0.87mm, p<0.05), the waist-hip ratio (1.09 vs. 0.93, p<0.05) and the body fat contents (32% vs. 27%, p<0.05).Insulin resistance was assessed by the short insulin tolerance test, and the insulin resistance (IR) group was defined as having a Kitt less than 2.5%/min.
CONCLUSION
These results suggest that insulin resistance is an important risk factor for CAD, and is related to the severity of coronary atherosclerosis.