Korean Circ J.  2010 Feb;40(2):62-67. 10.4070/kcj.2010.40.2.62.

Diabetes, Insulin Resistance and Atherosclerosis Surrogates in Patients With Coronary Atherosclerosis

• Park HW
• Kown TG
• Kim KY
• Bae JH

• KMID: 2297940
• DOI: http://doi.org/10.4070/kcj.2010.40.2.62

Abstract

BACKGROUND AND OBJECTIVES
Undiagnosed diabetes mellitus (DM) or impaired glucose tolerance (IGT) is not uncommon in patients with coronary atherosclerosis and is known to be associated with abnormal scores for atherosclerosis surrogates. We sought to determine the prevalence of undiagnosed DM or IGT, and the association between insulin resistance (IR) and atherosclerosis surrogates in patients with coronary atherosclerosis.
SUBJECTS AND METHODS
The study population consisted of 187 consecutive patients with angiographically proven coronary atherosclerosis (mean: 61 years old, 94 males). We measured carotid intima-media thickness (IMT) and flow mediated brachial artery dilatation (FMD). We also did oral glucose tolerance tests (OGTT), quantitative insulin-sensitivity check indexes (QUICKI) and homeostasis model assessment-IR (HOMA-IR).
RESULTS
Abnormal OGTT was found in 164 patients (87.7%), even though there were only 63 known cases of DM (33.7%). There were 58 patients (31%) with newly diagnosed IGT and 43 patients (23%) with newly diagnosed DM. There were 71 patients (38%) who had IR (defined as measured HOMA-R > or =3.0). HOMA-IR showed a positive correlation with body mass index (BMI) (r=0.275, p<0.001) and triglycerides (r=0.2, p=0.01), whereas QUICKI had a negative correlation with BMI (r=-0.26, p<0.001), total cholesterol (r=-0.15, p=0.04), triglycerides (r=-0.21, p=0.004) and low-density lipoprotein-cholesterol (LDL-C) (r=-0.17, p=0.02). HOMA-IR and QUICKI were not significantly correlated with IMT or FMD.
CONCLUSION
This study suggests that there is a high incidence of undiagnosed DM and IGT, but atherosclerosis surrogates are not associated with IR in patients with coronary atherosclerosis.

Keyword

Coronary atherosclerosis; Diabetes; Insulin resistance

MeSH Terms

Atherosclerosis
Body Mass Index
Brachial Artery
Carotid Intima-Media Thickness
Cholesterol
Coronary Artery Disease
Diabetes Mellitus
Dilatation
Glucose
Glucose Tolerance Test
Homeostasis
Humans
Incidence
Insulin
Insulin Resistance
Prevalence
Triglycerides
Cholesterol
Glucose
Insulin
Triglycerides

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