Insulin Sensitivity is Associated with the Presence and Extent of Coronary Artery Disease

Background and Objectives：Insulin resistance has been suggested to be an important risk factor in the development of arteriosclerosis. The correlation between insulin sensitivity and the degree of coronary atherosclerosis in patients with angina pectoris was investigated. Subjects and Methods：The study population consisted of 74 subjects with angina (54 men, 20 women, aged from 31 to 73 years. Coronary angiograms were evaluated by 3 semiquantitative scoring systems (vessel score, stenosis score and extent score to estimate the extent of focal and diffuse coronary artery disease (CAD. Insulin sensitivity (KITT was determined by an insulin tolerance test. Results：There were significant correlations between KITT and all 3 coronary scores. Multivariate analysis revealed significant and independent correlations between all 3 coronary scores and KITT, even in patients without diabetes mellitus. Both HDL cholesterol level and KITT were sign-ificantly lower in patients with CAD than in those without. Conclusion：Decreased insulin sensitivity was significantly associated with the presence and extent of CAD. These results suggest the potential benefits of insulin-sensitizing treatment strategies for patients with decreased insulin sensitivity. (Korean Circulation J 2002;32(7 :566-572