Proinsulin is an independent predictor of the angiographical characteristics of coronary atherosclerosis.
OBJECTIVE
The objective of this survey was to study the association between circulating proinsulin level and the severity of coronary atherosclerosis.


METHODS
The study population consisted of 1,039 consecutive patients (775 males and 264 females) who underwent coronary angiography for suspected or known coronary atherosclerosis. The patients' anthropometric and plasma measurements including body mass index, blood pressure, blood lipid, blood glucose, and proinsulin level were performed. The severity of coronary atherosclerosis was defined by the Gensini's score system.


RESULTS
When proinsulin level was examined as a categorical variable classified by quartile values, subjects with a high proinsulin level had significantly higher values of Gensini's score than those with a low proinsulin level (p = 0.000). The Spearman correlation analysis suggests that the Gensini's score was significantly correlated with proinsulin level (r = -0.177, p = 0.000). Multiple stepwise linear regression analysis demonstrated that glucose (beta= 0.136, p = 0.000), age (beta= 0.189, p = 0.000), proinsulin (beta= 0.135, p=0.000), SBP (mm Hg) (beta= -0.061, p = 0.043), fasting low-density lipoprotein cholesterol (mmol/l) (beta= 0.141, p = 0.003), and total cholesterol (beta= -0.105, p = 0.029) are significantly independently associated with the Gensini's score.


CONCLUSIONS
Proinsulin is a strong and statistically highly significant pre- dictor of coronary atherosclerosis independent of the other major risk factors including age, body mass index, blood pressure, fasting blood glucose, and blood lipid. The exact mechanisms need further study.
Jia
En-Zhi
EZ
Department of Cardiovascular Medicine, First Affiliated Hospital of Nanjing Medical University, Nanjing, China. enzhijia@yahoo.com.cn
Yang
Zhi-Jian
ZJ
Zhu
Tie-Bing
TB
Wang
Lian-Sheng
LS
Chen
Bo
B
Cao
Ke-Jiang
KJ
Huang
Jun
J
Ma
Wen-Zhu
WZ
D000368:Aged; D001786:Blood Glucose / Q000032:analysis; D015992:Body Mass Index; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000097:blood* / Q000000981:diagnostic imaging; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011384:Proinsulin / Q000097:blood*; D018709:Statistics, Nonparametric
D001786:Blood Glucose; D011384:Proinsulin