Role of hyperinsulinemia in atherosclerotic coronary arterial disease: Studies of semi-quantitative coronary angiography

Objective To evaluate the role of insulin resistance on coronary atheroscle rosis, angiographic semiquantitative scores of coronary stenosis and calcif ication were evaluated, Subjects and Methods Ninety-five non-diabetic subje cts with coronary arterial disease were selected from our angiographic data base. Hyperinsulinemia was defined as a serum insulin level of greater tha n or equal to 60.4 IU/l at 120 minutes after 75 g oral glucose challenge. R esults Twenty-three (24 %) of the patients exhibited hyperinsulinemia. Ther e was no difference in age or gender between the two subgroups. The inciden ce of hypertension, smoking habits, hypercholesterolemia, and hyperuricemia were also the same among the insulin resistance subgroups. Subjects with h yperinsulinemia had higher coronary artery scores of stenosis (11.9+/-5.6 v s 8.3+/-5.0, p<0.0001) and calcification (7.5+/-6.3 vs 4.8+/-4.9, p<0.0001) , Moreover, the stenosis score had a close linear correlation with the 120 minutes serum insulin level (r=0.266, p=0.009), but not with the fasting le vel, Conclusion These results suggest that hyperinsulinemia is a risk for c oronary arterial disease, and emphasize the severity of coronary atheroscle rosis in normal glucose tolerant subjects.