Effects of insulin resistance on coronary arterial lesion in diabetic patients with coronary heart disease

Objective To investigate the changes of insulin sensitivity index and serum lipid in coronary heart disease (CHD) with various degrees of coronary arterial lesion and their significance. Methods A total of 29 CHD patients with diabetes were divided into 2 groups according to the degrees of the maximal stenosis of the major coronary artery branch and the angiographic morphology of plaques: severe lesion group (SG, narrowness of luminal diameter 50% and types 2 and 3 of plaque morphology) and mild lesion group (MG, narrowness of luminal diameter 50% and type 1 of plaque morphology). Meanwhile, normal coronary angiographs of 16 healthy people served as the control group (CG). The serum levels of fasting plasma glucose and fasting insulin, 2 h postprandial plasma glucose and insulin levels, insulin sensitivity index and serum lipid in each group were determined. Results The serum levels of fasting plasma glucose and fasting insulin, 2 h postprandial plasma glucose and insulin levels, and insulin sensitivity index and serum lipid in CHD patients with diabetes were significantly higher than those in CG ( P 0 05). The parameters mentioned above in SG were markedly higher than those in MG. Conclusion The changes of serum levels of fasting plasma glucose and fasting insulin, 2 h postprandial plasma glucose and insulin levels, insulin sensitivity index and serum lipid may be associated with coronary arterial lesion of CHD patients. Insulin resistance may deteriorate coronary arterial lesion in CHD patients with diabetes.