Insulin sensitivity and the diffuseness of coronary artery disease in humans.
OBJECTIVE
To study the relationship between insulin sensitivity and diffuse coronary artery disease.


METHODS
Ninety-two consecutive patients underwent coronary angiography were enrolled in the study. Relationships between the results of angiograms and both glucose tolerance and blood lipids were analyzed.


RESULTS
The mean age of the 92 patients (70 males, 22 females) was 65.4 +/- 6.3 y. In the 78 patients diagnosed by angiography as coronary artery disease, diffuse lesion was more common in diabetic patients than in those without a diabetes history (12/13 vs 24/65, P = 0.00026). Fasting glucose [(6.06 +/- 2.43) x 10(-3) mol/L vs (4.80 +/- 1.47) x 10(-3) mol/L, P = 0.009], glucose levels at one hour [(12.37 +/- 4.38) x 10(-3) mol/L vs (9.10 +/- 3.97) x 10(-3) mol/L, P = 0.001], two hours [(11.12 +/- 5.64) x 10(-3) mol/L vs (7.49 +/- 4.29) x 10(-3) mol/L, P = 0.003] and three hours [(8.11 +/- 5.51) x 10(-3) mol/L vs (5.56 +/- 3.46) x 10(-3) mol/L, P = 0.020] after food were higher in patients with diffuse coronary disease than in those with non-diffuse coronary disease. Differences in the insulin sensitivity index (ISI) between the two groups was statistically significant (-4.36 +/- 0.52 vs -3.89 +/- 0.69, P = 0.003). The incidence of multiple-vessel disease in diabetic patients was higher than that in non-diabetic patients (12/13 vs 33/65, P = 0.00565). Glucose levels at two hours [(10.22 +/- 5.57) x 10(-3) mol/L vs (7.67 +/- 4.43) x 10(-3) mol/L, P = 0.034] and three hours [(7.90 +/- 5.47) x 10(-3) mol/L vs (5.22 +/- 2.79) x 10(-3) mol/L, P = 0.007] after food were higher in patients with multiple-vessel disease than in those with single-vessel disease. Impaired insulin sensitivity without a history of diabetes mellitus was commonly seen in patients with coronary artery disease.


CONCLUSIONS
The diffuseness of coronary artery disease is associated with insulin sensitivity and blood glucose levels. Insulin resistance is a common phenomenon in non-diabetic patients.
Hong
Tao
T
Department of Cardiology, Peking University First Hospital, Beijing 100034, China. dr-hongtao@yahoo.com.cn
Zhao
Guoan
G
Gao
Wei
W
Huo
Yong
Y
Zhu
Guoying
G
D000368:Aged; D001786:Blood Glucose / Q000032:analysis; D003326:Coronary Circulation; D003327:Coronary Disease / Q000209:etiology*; D005260:Female; D006801:Humans; D006946:Hyperinsulinism / Q000150:complications; D007333:Insulin Resistance; D008055:Lipids / Q000097:blood; D016015:Logistic Models; D008297:Male; D008875:Middle Aged
D001786:Blood Glucose; D008055:Lipids