PMID- 26753001
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20160112
LR  - 20201001
IS  - 1758-5996 (Print)
IS  - 1758-5996 (Electronic)
IS  - 1758-5996 (Linking)
VI  - 7
DP  - 2015
TI  - HOMA-IR is associated with significant angiographic coronary artery disease in 
      non-diabetic, non-obese individuals: a cross-sectional study.
PG  - 100
LID - 10.1186/s13098-015-0085-5 [doi]
LID - 100
AB  - 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.
FAU - Mossmann, Marcio
AU  - Mossmann M
AD  - Cardiology Division, Hospital de Clinicas de Porto Alegre, Universidade Federal 
      do Rio Grande do Sul, Ramiro Barcellos 2350, Porto Alegre, 90035-903 Brazil.
FAU - Wainstein, Marco V
AU  - Wainstein MV
AD  - Cardiology Division, Hospital de Clinicas de Porto Alegre, Universidade Federal 
      do Rio Grande do Sul, Ramiro Barcellos 2350, Porto Alegre, 90035-903 Brazil.
FAU - Goncalves, Sandro C
AU  - Goncalves SC
AD  - Cardiology Division, Hospital de Clinicas de Porto Alegre, Universidade Federal 
      do Rio Grande do Sul, Ramiro Barcellos 2350, Porto Alegre, 90035-903 Brazil.
FAU - Wainstein, Rodrigo V
AU  - Wainstein RV
AD  - Cardiology Division, Hospital de Clinicas de Porto Alegre, Universidade Federal 
      do Rio Grande do Sul, Ramiro Barcellos 2350, Porto Alegre, 90035-903 Brazil.
FAU - Gravina, Gabriela L
AU  - Gravina GL
AD  - Universidade Federal do Rio Grande do Sul, Ramiro Barcellos 2350, Porto Alegre, 
      90035-903 Brazil.
FAU - Sangalli, Marlei
AU  - Sangalli M
AD  - Universidade Federal do Rio Grande do Sul, Ramiro Barcellos 2350, Porto Alegre, 
      90035-903 Brazil.
FAU - Veadrigo, Francine
AU  - Veadrigo F
AD  - Universidade Federal do Rio Grande do Sul, Ramiro Barcellos 2350, Porto Alegre, 
      90035-903 Brazil.
FAU - Matte, Roselene
AU  - Matte R
AD  - Universidade Federal do Rio Grande do Sul, Ramiro Barcellos 2350, Porto Alegre, 
      90035-903 Brazil.
FAU - Reich, Rejane
AU  - Reich R
AD  - Universidade Federal do Rio Grande do Sul, Ramiro Barcellos 2350, Porto Alegre, 
      90035-903 Brazil.
FAU - Costa, Fernanda G
AU  - Costa FG
AD  - Universidade Federal do Rio Grande do Sul, Ramiro Barcellos 2350, Porto Alegre, 
      90035-903 Brazil.
FAU - Bertoluci, Marcello C
AU  - Bertoluci MC
AD  - Internal Medicine Department, Hospital de Clinicas de Porto Alegre and Programa 
      de Pos-Graduacao em Medicina: Ciencias Medicas, Universidade Federal do Rio 
      Grande do Sul, Ramiro Barcellos 2350, Room 700, Porto Alegre, 90035-903 Brazil.
LA  - eng
PT  - Journal Article
DEP - 20151114
PL  - England
TA  - Diabetol Metab Syndr
JT  - Diabetology & metabolic syndrome
JID - 101488958
PMC - PMC4706182
EDAT- 2016/01/12 06:00
MHDA- 2016/01/12 06:01
PMCR- 2015/11/14
CRDT- 2016/01/12 06:00
PHST- 2015/05/21 00:00 [received]
PHST- 2015/10/06 00:00 [accepted]
PHST- 2016/01/12 06:00 [entrez]
PHST- 2016/01/12 06:00 [pubmed]
PHST- 2016/01/12 06:01 [medline]
PHST- 2015/11/14 00:00 [pmc-release]
AID - 85 [pii]
AID - 10.1186/s13098-015-0085-5 [doi]
PST - epublish
SO  - Diabetol Metab Syndr. 2015 Nov 14;7:100. doi: 10.1186/s13098-015-0085-5. 
      eCollection 2015.