Insulin resistance as predictor of the angiographic severity and extent of coronary artery disease

Figures & data

Table I. Demographic and clinical characteristics of the study population (n = 107).

	Group 1 HOMA IR <1.8 (n = 41)	Group 2 HOMA IR ⩾1.8 (n = 42)	Group 3 Diabetic subjects (n = 24)	P^a
Age (years)	60 (56–64)	63 (55–65)	58 (52–66)	0.591
Male/Female	25/16 (61/39)	35/7 (83/17)	20/4 (83/17)	0.035
BMI (kg/m^2)	25.7 (23.6–27.4)	27.9 (25.7–30.0)	28.3 (27.2–31.6)	<0.001
Waist circumference (cm)	98±10.4	105±11.3	108±9.4	<0.001
Current or former smoker	19 (46)	27 (64)	14 (58)	0.250
Hypertension	16 (39)	28 (67)	18 (75)	0.006
Previous myocardial infarction	13 (32)	18 (43)	7 (29)	0.434
Previous cerebrovascular disease	1 (2)	3 (7)	0 (0)	0.290
Canadian Cardiovascular Society class:
I	2 (5)	3 (7)	2 (8)	0.887
II	22 (54)	17 (41)	7 (29)	0.143
III	17 (41)	19 (45)	13 (54)	0.609
IV	‐	3 (7)	2 (9)	0.277
Medication use at baseline:
Aspirin	38 (93)	37 (88)	24 (100)	0.209
β‐blocker	33 (81)	36 (86)	21 (88)	0.708
Statin	27 (66)	33 (79)	16 (68)	0.384
Angiotensin‐converting enzyme inhibitor	7 (17)	13 (31)	11 (46)	0.045
Calcium channel blocker	7 (17)	9 (21)	5 (21)	0.870
Diuretics	4 (10)	4 (10)	5 (21)	0.335
Long‐acting nitrates	16 (39)	20 (48)	13 (54)	0.474
Oral/diabetes	‐	‐	7 (29)	<0.001
Later treatment of CAD:
Medical	20 (49)	11 (26)	6 (25)	0.051
Percutaneous coronary intervention	13 (31)	20 (48)	11 (46)	0.293
Coronary artery bypass grafting	8 (20)	11 (26)	7 (29)	0.637

Data are expressed as means±SD, medians (interquartile ranges) or as frequencies (%).

^aP‐values from analysis of variance (means of continuous variables) or chi‐square test (frequency data) across the three groups.

Table II. Biochemical characteristics and other study variables.

	Group 1 HOMA IR <1.8 (n = 41)	Group 2 HOMA IR ⩾1.8 (n = 42)	Group 3 Diabetic subjects (n = 24)	P^a
Total cholesterol (mmol/L)	5.74±1.18	5.66±1.27	5.48±1.43	0.728
HDL cholesterol (mmol/L)	1.45±0.32	1.28±0.25	1.22±0.27	0.003
LDL cholesterol (mmol/L)	3.58±1.00	3.57±0.99	3.11±0.89	0.128
Triglycerides (mmol/L)	1.66 (1.23–2.20)	1.99 (1.44–2.36)	1.82 (1.44–3.76)	0.058
LDL particle size (nm)	26.00 (25.55–26.50)	25.50 (24.40–26.30)	24.70 (24.05–26.35)	0.026
ApoA‐I (mmol/L)	3.70 (3.26–4.18)	3.24 (3.03–3.82)	3.31 (2.87–3.83)	0.016
ApoA‐II (mmol/L)	0.93 (0.84–1.11)	0.93 (0.81–1.14)	0.84 (0.72–1.01)	0.070
ApoB (mmol/L)	3.02±0.74	3.28±0.84	3.28±1.05	0.406
LpA‐I (mmol/L)	1.37±0.44	1.22±0.37	1.24±0.26	0.237
LpA‐I/A‐II (mmol/L)	2.38±0.50	2.20±0.43	2.04±0.45	0.018
Fasting plasma glucose (mmol/L)	5.2 (4.9–5.6)	5.4 (5.2–5.7)	7.1 (6.5‐7.9)	<0.001
1‐hour plasma glucose (mmol/L)	8.2 (6.0–10.4)	9.2 (7.3–10.1)	12.7 (11.1–15.6)	<0.001
2‐hour plasma glucose (mmol/L)	6.1 (5.1–7.4)	6.6 (4.9–7.9)	11.8 (7.8–15.1)	<0.001
Fasting plasma insulin (mU/L)	4.9 (4.2–6.4)	9.8 (8.3–15.6)	11.9 (6.6–20.9)	<0.001
1‐hour plasma insulin (mU/L)	46.7 (28.4–61.4)	64.5 (49.9–109.4)	58.2 (42.1–85.9)	0.001
2‐hour plasma insulin (mU/L)	35.8 (25.1–43.7)	52.5 (33.6–84.1)	55.4 (27.8–98.1)	0.004

Data are presented as means±SD or as medians (interquartile ranges).

^aP‐values from analysis of variance (means of continuous variables) across the three groups.

Figure 1. Box plots showing median(horizontal lines), 25th to 75th percentiles (boxes), and 95th percentiles (whiskers) in the different groups by global percent diameter stenosis index (A), global extent index (B), and global atheroma burden index (C), respectively. P¹² value indicates comparison between group 1 (HOMA IR <1.8) and group 2 (HOMA IR ⩾1.8) and P¹³ value between group 1 (HOMA IR <1.8) and group 3 (diabetic subjects). P‐values from analysis of covariance with adjustment for age and gender. For definition of indexes, see Methods.

Table III. Quantitative coronary angiography results.

	Group 1 HOMA IR <1.8 (n = 41)	Group 2 HOMA IR ⩾1.8 (n = 42)	P^a	Group 3 Diabetic subjects (n = 24)	P^b
PDS index
Left main coronary artery	0 (0–0)	0 (0–0)	0.680	0 (0–0)	0.123
Proximal segment	9 (0–17)	16 (8–23)	0.391	14 (2–24)	0.587
Mid segment	10 (0–26)	20 (15–30)	0.227	22 (8–30)	0.519
Distal segment	12 (6–23)	20 (16–24)	0.016	24 (13–34)	0.002
Extent index
Left main coronary artery	0 (0–0)	0 (0–0)	0.586	0 (0–0)	0.147
Proximal segment	10 (0–23)	16 (5–27)	0.596	19 (2–24)	0.495
Mid segment	8 (0–23)	18 (13–27)	0.085	13 (6–26)	0.545
Distal segment	10 (5–15)	15 (10–18)	0.037	15 (8–22)	0.026
Atheroma burden index
Left main coronary artery	0 (0–0)	0 (0–0)	0.424	0 (0–0)	0.160
Proximal segment	5 (0–14)	8 (2–19)	0.307	9 (1–16)	0.157
Mid segment	4 (0–13)	10 (6–18)	0.128	8 (2–15)	0.362
Distal segment	4 (1–7)	6 (4–8)	0.125	6 (3–11)	0.048

Values are expressed as medians (interquartile ranges).

^a P‐values are presented for analysis of covariance between groups 1 and 2 with adjustment for age and gender.

^bP‐values are presented for analysis of covariance between groups 1 and 3 with adjustment for age and gender.

Table IV. Multivariate regression model of global percent diameter stenosis index.

Independent variables	Nondiabetic subjects (n = 83)
	Beta		P
Age (log)	0.160		0.140
Gender	‐0.434		0.002
HOMA IR group	0.284		0.010
Hypertension	‐0.016		0.881
Current or former smoking	0.163		0.158
LDL cholesterol	0.048		0.639
HDL cholesterol	‐0.127		0.274
Triglycerides (log)	0.006		0.954
Waist circumference	‐0.227		0.059
Adjusted R^2 and F‐ratio	0.297	4.806	<0.001

log = logarithmic transformation of the variable.