Association of coronary atherosclerosis with insulin resistance in patients with impaired glucose tolerance.
OBJECTIVE
The purpose of the study was to evaluate the role of insulin resistance (IR) in the development of coronary atherosclerosis in patients with impaired glucose tolerance.


RESULTS
The study group consisted of 42 patients with impaired glucose tolerance. Based upon coronary angiography the patients were divided into group A--with prior myocardial infarction and critical coronary stenosis (n=20) and group B--without prior myocardial infarction and without critical coronary stenosis (n=22). In each patient glucose disposal rate (GDR) during metabolic clamp, insulinaemia in the fasting state and during the clamp, glycaemia during oral glucose tolerance test (OGTT), BMI and body mass composition were measured. The groups did not differ in age, BMI, percent fat content and distribution, and blood pressure. Fasting insulinaemia (56.7 microU/ml) was higher in group A than in group B (22.3 microU/ml). GDR in group A (2.96 mg/kg b.m./min) was lower than in group B (5.36 mg/kg b.m./min). There was a negative correlation between the number of critically narrowed coronary vessels and GDR in group A. GDR below 3.97 mg/kg b.m./min was found, based on regression analysis, to be a powerful risk factor for myocardial infarction.


CONCLUSIONS
The relationship between IR and severity of coronary atherosclerosis implies its unfavourable role in the development of atherosclerosis. The present findings indicate a negative role of IR in the development of myocardial infarction and suggest that it is an independent risk factor, which identifies high-risk patients requiring treatment that would increase tissue insulin sensitivity.
Stochmal
Ewa
E
Department of Endocrinology Jagiellonian University Medical College, Kraków, Poland. estochma@cm-uj.krakow.pl
Szurkowska
Magdalena
M
Czarnecka
Danuta
D
Stochmal
Anna
A
Klecha
Artur
A
Kawecka-Jaszcz
Kalina
K
Szybiński
Zbigniew
Z
D000328:Adult; D015897:Comorbidity; D003324:Coronary Artery Disease / Q000453:epidemiology / Q000503:physiopathology*; D018450:Disease Progression; D005260:Female; D018149:Glucose Intolerance / Q000453:epidemiology / Q000503:physiopathology*; D005951:Glucose Tolerance Test; D006801:Humans; D007333:Insulin Resistance; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology; D012372:ROC Curve; D012044:Regression Analysis