Author + information
- Chang Xuewei1,2,
- Shouyan Zhang1,
- Huifang Ma1,
- Liping Tian1,
- Yidong Wei3,
- Jinghan Wei2 and
- Chunguang Qiu2
To study the relationship between insulin resistance and coronary collateral vessel formation in patients with impaired glucose tolerance.
This study enrolled 20 control subjects, and 187 patients with impaired glucose tolerance, who underwent coronary angiography. We prospectively selected all patients who had at least one total occlusion of a major coronary. The homeostasis model assessment of insulin resistance and quantitative insulin sensitivity check index were used to quantify insulin resistance (HOMA2-IR). The severity scale of coronary artery stenosis was quantitatively assessed according to coronary angiography by Gensini scoring system. The collateral scoring system developed by Rentrop and Cohen was used. All statistic work was carried out with software of SPSS 13.0.
HbA1c, Fasting insulin (FINS) and HOMA2-IR were (5.16±1.15)%, (7.45±1.31) pmol/L and 0.17±0.10 in control, (5.67±1.21)%, (7.85±1.41) pmol/L and 0.23±0.15 in Rentrop 3 group, (5.75±1.24)%, (8.06±1.50) pmol/L and 0.24±0.16 in Rentrop 2 group, (6.11±1.31)%, (8.19±1.57) pmol/L and 0.27±0.18 in Rentrop 1 group, (6.38±1.40)%, (8.89±1.66) pmol/L and 0.32±0.21 in Rentrop 0 group. Compared with good collateral group and control, HbA1c, FINS and HOMA2-IR were significantly higher in poor collateral group (P<0.05). The stepwise multivariable regression analysis shown that HOMA2-IR (R=6.518, P<0.05), HbA1c (R=1.916, P<0.05), 2h-PBG (R=1.130, P<0.05) and FINS (R=1.547, P<0.05) were significant independent predictor for the severity scale of coronary artery stenosis. The binary regression analysis shown, HOMA2-IR (OR=1.679, 95% CI: 1.101-2.558, P=0.016) enter the coronary collateral grade regression equation eventually. HOMA2-IR was the significantly independent predictor for poor coronary collateral.
This study shows that insulin resistance is significantly higher in impaired glucose tolerance patients with coronary occlusion. The severity scale of coronary artery stenosis and the poor coronary collateral are partly related to insulin resistance.