PMID- 36238131
OWN - NLM
STAT- MEDLINE
DCOM- 20221017
LR  - 20221207
IS  - 1540-8183 (Electronic)
IS  - 0896-4327 (Print)
IS  - 0896-4327 (Linking)
VI  - 2022
DP  - 2022
TI  - Relationship among Insulin Therapy, Insulin Resistance, and Severe Coronary 
      Artery Disease in Type 2 Diabetes Mellitus.
PG  - 2450024
LID - 10.1155/2022/2450024 [doi]
LID - 2450024
AB  - OBJECTIVES: The effect of insulin therapy on coronary artery disease (CAD) 
      remains controversial. This study aimed to analyze the association between 
      insulin resistance and the morbidity of severe CAD in type 2 diabetes mellitus 
      (T2DM). METHODS: A total of 2044 T2DM patients aged >/=40 years were included in 
      this cross-sectional observational study. Clinical information and laboratory 
      results were collected from the medical records. Those who underwent percutaneous 
      coronary intervention (PCI) were classified as severe CAD, while those who did 
      not have a history of and were not suffering from CAD were classified as patients 
      without CAD. RESULTS: T2DM patients with severe CAD and without CAD had no 
      significant differences in glycosylated hemoglobin A1c (8.55% +/- 2.10% vs. 
      8.39% +/- 1.77%, P=0.234). The proportion of insulin treatment was also similar 
      between the two groups (56.85% vs. 53.65%, odds ratio = 1.138, P=0.310). In the 
      patients without insulin treatment, the levels of fasting C peptide (FCP) 
      correlated with severe CAD prevalence. FCP was categorized into 3 tertiles 
      (<1.5 ng/mL, 1.5 ng/mL- 3 ng/mL, and >/=3 ng/mL), and the prevalence rates of 
      severe CAD were 7.88%, 14.31%, and 18.28%, respectively (P < 0.05). In the 
      patients with insulin treatment, the body mass index (BMI) was the significant 
      risk factor of severe CAD. The prevalence of severe CAD according to BMI tertiles 
      (<24 kg/m(2), 24 kg/m(2)-28 kg/m(2), and >/=28 kg/m(2)) was 11.22%, 14.61%, and 
      24.62%, respectively (P < 0.01). CONCLUSIONS: Our results showed that insulin 
      resistance, rather than insulin therapy, increases the risk of severe CAD in T2DM 
      patients with inadequate glycemic control. Non-insulin treated patients with high 
      FCP and insulin-treated patients with high BMI are at higher risk of severe CAD.
CI  - Copyright (c) 2022 Jing Song et al.
FAU - Song, Jing
AU  - Song J
AD  - Department of Endocrinology and Metabolism, Shanghai Eighth People's Hospital, 
      Shanghai, China.
FAU - Xia, Xinyi
AU  - Xia X
AD  - Department of Endocrinology and Metabolism, Shanghai Jiao Tong University School 
      of Medicine Affiliated Sixth People's Hospital, Shanghai Clinical Center for 
      Metabolic Diseases, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai, 
      China.
FAU - Lu, Ye
AU  - Lu Y
AD  - Department of Endocrinology and Metabolism, Shanghai Eighth People's Hospital, 
      Shanghai, China.
FAU - Wan, Jing
AU  - Wan J
AD  - Department of Endocrinology and Metabolism, Shanghai Eighth People's Hospital, 
      Shanghai, China.
FAU - Chen, Haibing
AU  - Chen H
AUID- ORCID: 0000-0002-2259-5522
AD  - Department of Endocrinology and Metabolism, Shanghai 10th People's Hospital, 
      Tongji University, Shanghai, China.
FAU - Yin, Jun
AU  - Yin J
AUID- ORCID: 0000-0002-9826-3583
AD  - Department of Endocrinology and Metabolism, Shanghai Eighth People's Hospital, 
      Shanghai, China.
AD  - Department of Endocrinology and Metabolism, Shanghai Jiao Tong University School 
      of Medicine Affiliated Sixth People's Hospital, Shanghai Clinical Center for 
      Metabolic Diseases, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai, 
      China.
LA  - eng
PT  - Journal Article
PT  - Observational Study
DEP - 20220926
PL  - United States
TA  - J Interv Cardiol
JT  - Journal of interventional cardiology
JID - 8907826
RN  - 0 (C-Peptide)
RN  - 0 (Glycated Hemoglobin A)
RN  - 0 (Insulin)
SB  - IM
MH  - C-Peptide
MH  - *Coronary Artery Disease/epidemiology
MH  - Cross-Sectional Studies
MH  - *Diabetes Mellitus, Type 2/complications/drug therapy/epidemiology
MH  - Glycated Hemoglobin
MH  - Humans
MH  - Insulin/therapeutic use
MH  - *Insulin Resistance
MH  - *Percutaneous Coronary Intervention
PMC - PMC9529512
COIS- The authors declare no conflicts of interests related to the present paper. The 
      requirements for authorship as stated earlier in this document have been met. 
      Each author believes that the manuscript represents honest work.
EDAT- 2022/10/15 06:00
MHDA- 2022/10/18 06:00
PMCR- 2022/09/26
CRDT- 2022/10/14 03:00
PHST- 2022/03/22 00:00 [received]
PHST- 2022/08/03 00:00 [revised]
PHST- 2022/08/11 00:00 [accepted]
PHST- 2022/10/14 03:00 [entrez]
PHST- 2022/10/15 06:00 [pubmed]
PHST- 2022/10/18 06:00 [medline]
PHST- 2022/09/26 00:00 [pmc-release]
AID - 10.1155/2022/2450024 [doi]
PST - epublish
SO  - J Interv Cardiol. 2022 Sep 26;2022:2450024. doi: 10.1155/2022/2450024. 
      eCollection 2022.