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HOMA-IR is associated with significant angiographic coronary artery disease in non-diabetic, non-obese individuals: a cross-sectional study
Insulin resistance is a major component of metabolic syndrome, type 2 Diabetes Mellitus (T2DM) and coronary artery disease (CAD). Although important in T2DM, its role as a predictor of CAD in non-diabetic patients is less studied. In the present study, we aimed to evaluate the association of HOMA-IR...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4706182/ https://www.ncbi.nlm.nih.gov/pubmed/26753001 http://dx.doi.org/10.1186/s13098-015-0085-5 |
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author | Mossmann, Márcio Wainstein, Marco V. Gonçalves, Sandro C. Wainstein, Rodrigo V. Gravina, Gabriela L. Sangalli, Marlei Veadrigo, Francine Matte, Roselene Reich, Rejane Costa, Fernanda G. Bertoluci, Marcello C. |
author_facet | Mossmann, Márcio Wainstein, Marco V. Gonçalves, Sandro C. Wainstein, Rodrigo V. Gravina, Gabriela L. Sangalli, Marlei Veadrigo, Francine Matte, Roselene Reich, Rejane Costa, Fernanda G. Bertoluci, Marcello C. |
author_sort | Mossmann, Márcio |
collection | PubMed |
description | Insulin resistance is a major component of metabolic syndrome, type 2 Diabetes Mellitus (T2DM) and coronary artery disease (CAD). Although important in T2DM, its role as a predictor of CAD in non-diabetic patients is less studied. In the present study, we aimed to evaluate the association of HOMA-IR with significant CAD, determined by coronary angiography in non-obese, non-T2DM patients. We also evaluate the association between 3 oral glucose tolerance test (OGTT) based insulin sensitivity indexes (Matsuda, STUMVOLL-ISI and OGIS) and CAD. We conducted a cross-sectional study with 54 non-obese, non-diabetic individuals referred for coronary angiography due to suspected CAD. CAD was classified as the “anatomic burden score” corresponding to any stenosis equal or larger than 50 % in diameter on the coronary distribution. Patients without lesions were included in No-CAD group. Patients with at least 1 lesion were included in the CAD group. A 75 g oral glucose tolerance test (OGTT) with measurements of plasma glucose and serum insulin at 0, 30, 60, 90 and 120 min was obtained to calculate insulin sensitivity parameters. HOMA-IR results were ranked and patients were also categorized into insulin resistant (IR) or non-insulin resistant (NIR) if they were respectively above or below the 75th percentile (HOMA-IR > 4.21). The insulin sensitivity tests results were also divided into IR and NIR, respectively below and above each 25th percentile. Chi square was used to study association. Poisson Regression Model was used to compare prevalence ratios between categorized CAD and IR groups. Results: Fifty-four patients were included in the study. There were 26 patients (48 %) with significant CAD. The presence of clinically significant CAD was significant associated with HOMA-IR above p75 (Chi square 4.103, p = 0.0428) and 71 % of patients with HOMA-IR above p75 had significant CAD. Subjects with CAD had increased prevalence ratio of HOMA-IR above p75 compared to subjects without CAD (PR 1.78; 95 % CI 1.079–2.95; p = 0.024). Matsuda index, Stumvoll-ISI and OGIS index were not associated with significant CAD. We concluded that, in patients without diabetes or obesity, in whom a coronary angiography study is indicated, a single determination of HOMA-IR above 4.21 indicates increased risk for clinical significant coronary disease. The same association was not seen with insulin sensitivity indexes such as Matsuda, Stunvoll-ISI or OGIS. These findings support the need for further longitudinal research using HOMA-IR as a predictor of cardiovascular disease. |
format | Online Article Text |
id | pubmed-4706182 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-47061822016-01-09 HOMA-IR is associated with significant angiographic coronary artery disease in non-diabetic, non-obese individuals: a cross-sectional study Mossmann, Márcio Wainstein, Marco V. Gonçalves, Sandro C. Wainstein, Rodrigo V. Gravina, Gabriela L. Sangalli, Marlei Veadrigo, Francine Matte, Roselene Reich, Rejane Costa, Fernanda G. Bertoluci, Marcello C. Diabetol Metab Syndr Research Insulin resistance is a major component of metabolic syndrome, type 2 Diabetes Mellitus (T2DM) and coronary artery disease (CAD). Although important in T2DM, its role as a predictor of CAD in non-diabetic patients is less studied. In the present study, we aimed to evaluate the association of HOMA-IR with significant CAD, determined by coronary angiography in non-obese, non-T2DM patients. We also evaluate the association between 3 oral glucose tolerance test (OGTT) based insulin sensitivity indexes (Matsuda, STUMVOLL-ISI and OGIS) and CAD. We conducted a cross-sectional study with 54 non-obese, non-diabetic individuals referred for coronary angiography due to suspected CAD. CAD was classified as the “anatomic burden score” corresponding to any stenosis equal or larger than 50 % in diameter on the coronary distribution. Patients without lesions were included in No-CAD group. Patients with at least 1 lesion were included in the CAD group. A 75 g oral glucose tolerance test (OGTT) with measurements of plasma glucose and serum insulin at 0, 30, 60, 90 and 120 min was obtained to calculate insulin sensitivity parameters. HOMA-IR results were ranked and patients were also categorized into insulin resistant (IR) or non-insulin resistant (NIR) if they were respectively above or below the 75th percentile (HOMA-IR > 4.21). The insulin sensitivity tests results were also divided into IR and NIR, respectively below and above each 25th percentile. Chi square was used to study association. Poisson Regression Model was used to compare prevalence ratios between categorized CAD and IR groups. Results: Fifty-four patients were included in the study. There were 26 patients (48 %) with significant CAD. The presence of clinically significant CAD was significant associated with HOMA-IR above p75 (Chi square 4.103, p = 0.0428) and 71 % of patients with HOMA-IR above p75 had significant CAD. Subjects with CAD had increased prevalence ratio of HOMA-IR above p75 compared to subjects without CAD (PR 1.78; 95 % CI 1.079–2.95; p = 0.024). Matsuda index, Stumvoll-ISI and OGIS index were not associated with significant CAD. We concluded that, in patients without diabetes or obesity, in whom a coronary angiography study is indicated, a single determination of HOMA-IR above 4.21 indicates increased risk for clinical significant coronary disease. The same association was not seen with insulin sensitivity indexes such as Matsuda, Stunvoll-ISI or OGIS. These findings support the need for further longitudinal research using HOMA-IR as a predictor of cardiovascular disease. BioMed Central 2015-11-14 /pmc/articles/PMC4706182/ /pubmed/26753001 http://dx.doi.org/10.1186/s13098-015-0085-5 Text en © Mossmann et al. 2015 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Mossmann, Márcio Wainstein, Marco V. Gonçalves, Sandro C. Wainstein, Rodrigo V. Gravina, Gabriela L. Sangalli, Marlei Veadrigo, Francine Matte, Roselene Reich, Rejane Costa, Fernanda G. Bertoluci, Marcello C. HOMA-IR is associated with significant angiographic coronary artery disease in non-diabetic, non-obese individuals: a cross-sectional study |
title | HOMA-IR is associated with significant angiographic coronary artery disease in non-diabetic, non-obese individuals: a cross-sectional study |
title_full | HOMA-IR is associated with significant angiographic coronary artery disease in non-diabetic, non-obese individuals: a cross-sectional study |
title_fullStr | HOMA-IR is associated with significant angiographic coronary artery disease in non-diabetic, non-obese individuals: a cross-sectional study |
title_full_unstemmed | HOMA-IR is associated with significant angiographic coronary artery disease in non-diabetic, non-obese individuals: a cross-sectional study |
title_short | HOMA-IR is associated with significant angiographic coronary artery disease in non-diabetic, non-obese individuals: a cross-sectional study |
title_sort | homa-ir is associated with significant angiographic coronary artery disease in non-diabetic, non-obese individuals: a cross-sectional study |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4706182/ https://www.ncbi.nlm.nih.gov/pubmed/26753001 http://dx.doi.org/10.1186/s13098-015-0085-5 |
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