title: [Association of microalbuminuria and fasting insulin levels with presence and severity of coronary artery disease in non-diabetic cases].
abstract: OBJECTIVE
  In this study, we aimed to determine the relation of presence and severity of coronary artery disease with microalbuminuria, fasting insulin levels and the classical risk factors in non-diabetic patients.
  
  
  METHODS
  We enrolled 100 non-diabetic patients that had an indication for coronary angiography. Group 1 consisted of 55 patients with coronary artery disease, and 45 patients without coronary artery disease were included in Group 2. The study was cross-sectional and case-controlled. In all patients 24-hour microalbuminuria, serum total, high density lipoprotein (HDL), low density lipoprotein (LDL) cholesterol and lipoprotein a, triglyceride, fasting blood sugar levels were obtained. Fasting insulin levels were determined and routine urinary tests were performed. Gensini scoring was done for determination of the severity of coronary artery disease. Statistical analysis was performed using unpaired t test, Mann-Whitney U test, Chi-square test, ROC analysis and multiple logistic regression analysis.
  
  
  RESULTS
  Microalbuminuria levels (p<0.001), fasting insulin levels (p<0.001), mean age (p=0.01), pulse pressure (p=0.014), LDL cholesterol levels (p=0.004), lipoprotein a levels (p<0.001) were significantly higher and HDL cholesterol levels were significantly lower (p=0.015) in Group 1 compared to the Group 2. Male gender was more frequent in Group 1 (p<0.001). With cut-off values defined by ROC analysis microalbuminuria (18 microgr/min, sensitivity: 91%, specificity: 45%, area under the curve: 0.790, 95% CI 2.43-15.96, p<0.001) increased probability of coronary artery disease by 6.2-fold and fasting insulin level higher than 10 microIU/ml by 11 folds at multivariate logistic regression analysis. When the cases were evaluated according to the Gensini scoring there was a significant association of coronary artery disease and microalbuminuria (r=0.52, p<0.001).
  
  
  CONCLUSIONS
  We concluded that in non-diabetic cases microalbuminuria and increased fasting insulin levels were predictors of presence and the severity of coronary artery disease and can be suggested as risk factors.
authors.affiliation: Uludağ Universitesi Tip Fakültesi Kardiyoloji Anabilim Dali Bursa, Türkiye.
authors.forename: Erkan
authors.initials: E
authors.lastname: Ekicibaşi
authors.forename: Aysel Aydin
authors.initials: AA
authors.lastname: Kaderli
authors.forename: Ali Riza
authors.initials: AR
authors.lastname: Kazazoğlu
authors.forename: Bülent
authors.initials: B
authors.lastname: Ozdemir
mesh_terms: D000419:Albuminuria / Q000150:complications / Q000503:physiopathology*; D001786:Blood Glucose; D016022:Case-Control Studies; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000097:blood / Q000150:complications / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000503:physiopathology* / Q000652:urine; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus; D005215:Fasting; D005260:Female; D006801:Humans; D007328:Insulin / Q000097:blood*; D017270:Lipoprotein(a) / Q000097:blood; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012720:Severity of Illness Index; D014280:Triglycerides / Q000097:blood; D014421:Turkey / Q000453:epidemiology
chemical_list: D001786:Blood Glucose; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D007328:Insulin; D017270:Lipoprotein(a); D014280:Triglycerides