Effects of insulin resistance on coronary arterial lesion in coronary heart disease

Objective To investigate the changes and clinical significance of insulin sensitivity index(ISI) and serum lipid in patients with coronary heart disease(CHD) of coronary lesion with various degrees.Methods Totally 116 CHD patients respectively were divided into mild lesion group and severe lesion group,single-vessel stenosis group and multi-vessels stenoses group,stable angina group and unstable angina or acute myocardial infarction group,plaque type of Ⅰ,Ⅱ,Ⅲ group according to the degrees of coronary maximal stenoses,the number of coronary artery with stenosis and angiographic morophology of plaques.Meanwhile,32 healthy people with normal coronary arteriongraphy were selected as the control group.The fasting plasma glucose and insulin,fasting and postprandial 2-hour plasma glucose and insulin,ISI and serum lipid were determined,and the changes were observed.The status of insulin resistance(IR) was assessed by the ISI.Results The fasting plasma glucose and insulin,fasting and postprandial 2-hour plasma glucose and insulin and serum lipid in severe lesion group,multi-vessels stenoses group,unstable angina or acute myocardial infarction group and plaque type of Ⅱ,Ⅲ group were significantly higher than those in mild lesion group,single-vessel stenosis group,stable angina group and plaque type of Ⅰ group(P0.05).Patients in severe lesion group,multi-vessels stenosese group,unstable angina or acute myocardial infarction group and plaque type of Ⅱ,Ⅲ group had an increase in fasting insulin,a decrease in insulin sensitivity.There was no significant difference in fasting insulin level and insulin sensitivity between normal controls and mild lesion group,single-vessel stenosis group,stable angina group and plaque type of Ⅰ group(P0.05).Conclusion Hyperinsulinmia,IR and serious dyslipidaemia affects the scope,severity and stablity of the coronary artery lesions,and might play an important role in the development of coronary atherosclerosis.