Insulin resistance in non diabetic individuals with acute myocardial infarction and its relationship with acute phase reactants

Abstract

Aim: The current study was undertaken to assess the prevalence of insulin resistance (IR) in nondiabetic individuals with acute myocardial infarction (AMI) and to study the relationship between IR and acute-phase reactants in patients with AMI and to ascertain its prognostic significance. Materials and Methods: One hundred nondiabetic individuals with AMI were part of the study. A detailed physical examination and estimation of fasting blood sugar, 2 hPost prandial blood sugar (PPBS), fasting serum insulin, highly sensitive c-reactive protein (hsCRP), and lipid profile was done at admission and then after 3 months of follow-up. IR was calculated using Homeostatic model assessment IR (HOMA IR) and HOMA B method. HOMA IR value of >2 was considered as IR. Results: In the present study, the prevalence of IR was 63% (males = 63.4% females = 60.8%). hsCRP levels were elevated in 87.4% (hsCRP = 3.187 ± 1.4109 [mg/l]) of insulin-resistant individuals and 86.5% normal individuals (hsCRP = 3.950 ± 1.390 [mg/L]). At the end of 3 months, hsCRP levels in the group with IR was 2.346 ± 0.883 mg/L and in the group with no IR was 1.779 ± 0.875 mg/L (P = 0.043). The prevalence of metabolic syndrome in the study population was 24%. Mortality rate was higher in patients with IR at 3.2%. Conclusion: The study shows that the prevalence of IR is high, even in nondiabetic patients with coronary artery disease.Level of Hs CRP which is a marker of inflammation was found to be raised in the entire study population irrespective of insulin resistance status. However, in patients with IR, the level of hsCRP remained high even on follow-up study. IR and acute-phase reactants like hsCRP can be used in addition to the traditional risk factors to evaluate the progress and outcome of cardiovascular disease. The following core competencies are addressed in this article: Medical knowledge, Patient care, Practice-based learning and improvement, and Systems-based practice.