Insulin resistance and the severity of coronary artery disease based on obesity status in stable-angina patients: a cross-sectional analysisDeepak Uppunda, Ranjan Shetty, Pragna Rao, Abdul Razak, Ajit Singh, Sheetal Chauhan, Husena Vadnagarwala, Sridevi Prabhu, Umesh Pai.
The assessment of coronary artery disease (CAD) concerning the metabolic status and BMI is poorly studied. This study is planned to assess the association between insulin resistance (IR) and the severity of CAD based on the metabolic and phenotypic status in stable-angina patients. A cross-sectional study was conducted on 532 patients with stable angina who underwent coronary angiogram for the evaluation of CAD. Metabolic obesity was determined using the National Cholesterol Education Program-Adult Treatment Panel III (NCEPATP-III) criteria. Phenotypic obesity was defined as BMI â‰¥ 25 kg/m2. Homeostasis model assessment insulin resistance (HOMA-IR) in correlation with the severity of CAD was measured using SYNTAX Score. The mean age of the patients was 57.58 ± 10.40 years, and 69.4% were males. Out of 532 subjects, 51.3% were hypertensive, 14.5% were smokers, 29.1% consumed alcohol, 49.3% were metabolically obese, and 50% were phenotypically obese. Increase in insulin resistance increased the risk of severity of CAD in metabolically obese subjects (OR = 2.51, P = 0.048). In the phenotypically obese group, the association between insulin resistance and the severity of CAD was not statistically significant (OR = -2.19, P = 0.08). The study concludes that the increased insulin resistance increases the risk of severity of CAD in metabolically obese subjects.
Metabolic obesity; SYNTAX score; Coronary angiogram; Diabetes mellitus; Gycosylated haemoglobin