title: Association of insulin resistance and coronary artery remodeling: an intravascular ultrasound study.
abstract: BACKGROUND
  There are few studies that investigated the correlation between insulin resistance (IR) and the coronary artery remodeling. The aim of the study is to investigate the association of IR measured by homeostasis model assessment of insulin resistance (HOMA-IR) and coronary artery remodeling evaluated by intravascular ultrasound (IVUS).
  
  
  METHODS
  A total of 298 consecutive patients who received percutaneous coronary interventions under IVUS guidance were retrospectively enrolled. The value of HOMA-IR more than 2.5 was considered as IR positive. Metabolic syndrome was classified according to NCEP ATP III guidelines. The remodeling index was defined as the ratio of the external elastic membrane (EEM) area at the lesion site to the EEM area at the proximal reference site.
  
  
  RESULTS
  A total of 369 lesions were analyzed (161 lesions in HOMA-IR positive and 208 lesions in HOMA-IR negative). Remodeling index was significantly higher in the HOMA-IR positive group compared with the negative group (HOMA-IR positive vs. negative: 1.074 ± 0.109 vs. 1.042 ± 0.131, p = 0.013). There was a significant positive correlation between remodeling index and HOMA-IR (p = 0.010). Analysis of HOMA-IR according to remodeling groups showed increasing tendency of HOMA-IR, and it was statistically significant (p = 0.045). Multivariate analysis revealed that only HOMA-IR was an independent predictor of remodeling index (r = 0.166, p = 0.018).
  
  
  CONCLUSIONS
  Increased IR estimated by HOMA-IR was significantly associated with a higher remodeling index and positive coronary artery remodeling.
authors.affiliation: Department of Cardiology, CHA Bundang Medical Center, CHA University, Seongnam, South Korea.
authors.forename: Sang-Hoon
authors.initials: SH
authors.lastname: Kim
authors.affiliation: Department of Cardiology, CHA Bundang Medical Center, CHA University, Seongnam, South Korea. answod77@naver.com.
authors.forename: Jae-Youn
authors.initials: JY
authors.lastname: Moon
authors.affiliation: Department of Cardiology, CHA Bundang Medical Center, CHA University, Seongnam, South Korea.
authors.forename: Yeong Min
authors.initials: YM
authors.lastname: Lim
authors.affiliation: Department of Cardiology, CHA Bundang Medical Center, CHA University, Seongnam, South Korea.
authors.forename: Kyung Ho
authors.initials: KH
authors.lastname: Kim
authors.affiliation: Department of Cardiology, CHA Bundang Medical Center, CHA University, Seongnam, South Korea.
authors.forename: Woo-In
authors.initials: WI
authors.lastname: Yang
authors.affiliation: Department of Cardiology, CHA Bundang Medical Center, CHA University, Seongnam, South Korea.
authors.forename: Jung-Hoon
authors.initials: JH
authors.lastname: Sung
authors.affiliation: Department of Diagnostic Radiology, CHA Bundang Medical Center, CHA University, Seongnam, South Korea.
authors.forename: Seung Min
authors.initials: SM
authors.lastname: Yoo
authors.affiliation: Department of Cardiology, CHA Bundang Medical Center, CHA University, Seongnam, South Korea.
authors.forename: In Jai
authors.initials: IJ
authors.lastname: Kim
authors.affiliation: Department of Cardiology, CHA Bundang Medical Center, CHA University, Seongnam, South Korea.
authors.forename: Sang-Wook
authors.initials: SW
authors.lastname: Lim
authors.affiliation: Department of Cardiology, CHA Bundang Medical Center, CHA University, Seongnam, South Korea.
authors.forename: Dong-Hun
authors.initials: DH
authors.lastname: Cha
authors.affiliation: Department of Cardiology, CHA Bundang Medical Center, CHA University, Seongnam, South Korea.
authors.forename: Seung-Yun
authors.initials: SY
authors.lastname: Cho
mesh_terms: D000368:Aged; D015331:Cohort Studies; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000601:surgery*; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology; D008875:Middle Aged; D015999:Multivariate Analysis; D062645:Percutaneous Coronary Intervention; D012189:Retrospective Studies; D015607:Stents; D025321:Surgery, Computer-Assisted; D018084:Ultrasonography, Interventional; D066253:Vascular Remodeling