Factors Correlating with Severity of Coronary Artery Disease in Type 2 Diabetic Patients on Treatment for More Than 5 Years
Mukund P. Srinivasan
Department of Internal Medicine, Kasturba Medical College, Manipal University, Mangalore, India.
Padmanabh K. Kamath
Department of Cardiology, Kasturba Medical College, Manipal University, Mangalore, India.
Narasimha D. Pai
Department of Cardiology, Kasturba Medical College, Manipal University, Mangalore, India.
Poornima A. Manjrekar
Department of Biochemistry, Kasturba Medical College, Manipal University, Mangalore, India.
Chakrapani Mahabala *
Department of Internal Medicine, Kasturba Medical College, Manipal University, Mangalore, India.
*Author to whom correspondence should be addressed.
Abstract
Aims: To evaluate the correlation between insulin resistance and other conventional risk factors with respect to severity of coronary artery disease (CAD) in patients with more than 5 years of treatment for type 2 diabetes mellitus.
Study Design: Cross-sectional study.
Place and Duration of Study: Department of Medicine and Department of Cardiology, Kasturba Medical College, Hospital Mangalore, between February 2013 and December 2013.
Methodology: 61 people with more than 5 years of type 2 diabetes who underwent coronary angiogram for the evaluation of CAD were recruited in this study. Insulin resistance (HOMA-IR), anthropometric and biochemical parameters were determined, and was correlated with severity of CAD which was assessed by syntax score.
Results: There was significant positive linear correlation between log HOMA-IR and syntax score in people with more than 5 years of type 2 diabetes [r=0.605 (95%CI 0.417–0.744), P<0.001]. The correlation of syntax score with other known risk factors of CAD was not significant. Further multivariate analysis after adjusting for conventional risk factors showed a significant association of Log-IR with severity of CAD in people with type 2 diabetes mellitus of more than 5 years of duration (β=0.667, P<0.001)
Conclusion: In type 2 diabetes mellitus with treatment more than 5 years of duration, high HOMA-IR appears to be a good indicator of severity of CAD in Type 2 diabetes mellitus and might be a marker of severity of disease, thus helping us in identifying high risk type 2 diabetes mellitus subjects.
Keywords: Insulin Resistance, type 2 diabetes mellitus, coronary artery disease, syntax score.