HOMA-IR is associated with significant angiographic coronary artery disease in non-diabetic, non-obese individuals : a cross-sectional study
Autor(a) principal: | |
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Data de Publicação: | 2015 |
Outros Autores: | , , , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UFRGS |
Texto Completo: | http://hdl.handle.net/10183/196736 |
Resumo: | 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 crosssectional 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. HOMAIR 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. |
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Mossmann, MárcioWainstein, Marco VugmanGonçalves, Sandro CadavalWainstein, Rodrigo VugmanGravina, Gabriela LealSangalli, MarleiVeadrigo, FrancineMatte, RoseleneReich, RejaneCosta, Fernanda GuimarãesBertoluci, Marcello Casaccia2019-07-10T02:34:15Z20151758-5996http://hdl.handle.net/10183/196736000989720Insulin 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 crosssectional 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. HOMAIR 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.application/pdfengDiabetology and Metabolic Syndrome. São Paulo. Vol. 7, no. 100 (Nov. 2015), 7 p.Diabetes mellitus tipo 2Doença da artéria coronarianaResistência à insulinaHOMA-IR is associated with significant angiographic coronary artery disease in non-diabetic, non-obese individuals : a cross-sectional studyinfo:eu-repo/semantics/articleinfo:eu-repo/semantics/otherinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UFRGSinstname:Universidade Federal do Rio Grande do Sul (UFRGS)instacron:UFRGSTEXT000989720.pdf.txt000989720.pdf.txtExtracted Texttext/plain31791http://www.lume.ufrgs.br/bitstream/10183/196736/2/000989720.pdf.txte4db8f44cc190f65fa5fe4681c1481e9MD52ORIGINAL000989720.pdfTexto completo (inglês)application/pdf878461http://www.lume.ufrgs.br/bitstream/10183/196736/1/000989720.pdffab8941d48a380351de2a7b4e902fafdMD5110183/1967362019-07-11 02:35:10.308018oai:www.lume.ufrgs.br:10183/196736Repositório de PublicaçõesPUBhttps://lume.ufrgs.br/oai/requestopendoar:2019-07-11T05:35:10Repositório Institucional da UFRGS - Universidade Federal do Rio Grande do Sul (UFRGS)false |
dc.title.pt_BR.fl_str_mv |
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 |
spellingShingle |
HOMA-IR is associated with significant angiographic coronary artery disease in non-diabetic, non-obese individuals : a cross-sectional study Mossmann, Márcio Diabetes mellitus tipo 2 Doença da artéria coronariana Resistência à insulina |
title_short |
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_sort |
HOMA-IR is associated with significant angiographic coronary artery disease in non-diabetic, non-obese individuals : a cross-sectional study |
author |
Mossmann, Márcio |
author_facet |
Mossmann, Márcio Wainstein, Marco Vugman Gonçalves, Sandro Cadaval Wainstein, Rodrigo Vugman Gravina, Gabriela Leal Sangalli, Marlei Veadrigo, Francine Matte, Roselene Reich, Rejane Costa, Fernanda Guimarães Bertoluci, Marcello Casaccia |
author_role |
author |
author2 |
Wainstein, Marco Vugman Gonçalves, Sandro Cadaval Wainstein, Rodrigo Vugman Gravina, Gabriela Leal Sangalli, Marlei Veadrigo, Francine Matte, Roselene Reich, Rejane Costa, Fernanda Guimarães Bertoluci, Marcello Casaccia |
author2_role |
author author author author author author author author author author |
dc.contributor.author.fl_str_mv |
Mossmann, Márcio Wainstein, Marco Vugman Gonçalves, Sandro Cadaval Wainstein, Rodrigo Vugman Gravina, Gabriela Leal Sangalli, Marlei Veadrigo, Francine Matte, Roselene Reich, Rejane Costa, Fernanda Guimarães Bertoluci, Marcello Casaccia |
dc.subject.por.fl_str_mv |
Diabetes mellitus tipo 2 Doença da artéria coronariana Resistência à insulina |
topic |
Diabetes mellitus tipo 2 Doença da artéria coronariana Resistência à insulina |
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 crosssectional 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. HOMAIR 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. |
publishDate |
2015 |
dc.date.issued.fl_str_mv |
2015 |
dc.date.accessioned.fl_str_mv |
2019-07-10T02:34:15Z |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/other |
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http://hdl.handle.net/10183/196736 |
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1758-5996 |
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000989720 |
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http://hdl.handle.net/10183/196736 |
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Diabetology and Metabolic Syndrome. São Paulo. Vol. 7, no. 100 (Nov. 2015), 7 p. |
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