Insulin secretion and HOMA-IR in patients who underwent coronary angiography
Tatjana Isailovic, Milan Petakov, Sanja Ognjanovic, DJuro Macut, Bojana Popovic, Ivana Bozic, Valentina Elezovic & Svetozar Damjanovic
Introduction: Several population-based studies have shown that hyperinsulinemia and insulin resistance could be an independent predictive factor for development of coronary artery disease (CAD).
Aim: The aim of this cross-sectional study was to analyze insulin secretion in patients with proven coronary artery disease.
Methods: We have analyzed 151 consecutive patients (3579 years old, men 68%, women 32%) referred for coronary angiography due to suspected myocardial ischemia, as well as 62 age, sex and BMI matched healthy control subjects. Diabetes mellitus was excluded in all patients. Severity of CAD was estimated by the number of affected arteries (one, two or three major epicardial arteries) and by degree of luminal stenosis (less or more than 50%). Insulin resistance was assessed by HOMA-IR.
Results: Among those who underwent coronary angiography, 45 (29.8%) had normal coronary angiogram (NA) while CAD was diagnosed in 106 (70.2%) patients. More than 50% stenosis was found in 91(85.8%) patient. One artery was affected in 45(42.5%) patients, two arteries in 25(23.6%) while three arteries were affected in 36(33.9%) patients. Basal insulin concentration (17.2±0.9 vs. 18.2±0.7, P>0.05) as well as HOMA-IR (3.8±0.2 vs. 4.2±0.2, P>0.05) were not different in patients with NA and those with CAD. However, control subjects had significantly lower basal insulin and HOMA-IR in comparison to both NA and CAD (13.9±5.5 and 2.9±0.1, P<0.01, respectively). There was no correlation between the number of affected arteries and insulin concentration and HOMA-IR.
Conclusion: Similar clinical presentation and the level of insulin resistance in patients who underwent coronary angiography do not necessarily means the same pathological substrate.