Coronary spastic angina is associated with insulin resistance – possible involvement of endothelial dysfunction

Abstract

In this study, we examined whether coronary spastic angina (CSA) is associated with insulin resistance. There is increasing evidence that insulin resistance is associated with endothelial dysfunction. Patients with CSA show endothelial dysfunction. The study participants include 111 CSA patients (81 men and 30 women, mean age 62±12 years) and 53 participants without CSA (24 men and 29 women, mean age 63±10 years), serving as the controls. The oral glucose tolerance test was performed, and anthropometric parameters, plasma glucose and insulin levels, lipid profiles, and other laboratory parameters were evaluated. Homeostasis model assessment of insulin resistance (HOMA-IR), Log HOMA-IR, the quantitative insulin sensitivity check index, the insulin sensitivity index, and insulin resistance 60-120 min after glucose load (log post-glucose-IR) were calculated as surrogate markers of insulin resistance. The number of men, the number of smokers, log post-glucose-IR, the insulin sensitivity index, and fasting plasma glucose levels were higher in CSA patients compared with controls (P=0.001, 0.001, 0.004, 0.012, and 0.013, respectively), whereas plasma high-density lipoprotein cholesterol levels were lower (P<0.001). Insulin resistance on glucose load (log post-glucose-IR), plasma high-density lipoprotein cholesterol levels, and smoking were significantly associated with CSA (r=0.225, P=0.004; r=-0.313, P<0.001; and r=0.258, P=0.001, respectively).