Ozcan Turkay, Gen Ramazan, Akbay Esen, Horoz Mehmet, Akcay Burak, Genctoy Gultekin, Muslu Necati, Camsari Ahmet, Cicek Dilek, Gok Ebru, Kiykim Ahmet
Department of Cardiology, Mersin University Medical Faculty, Mersin, Turkey.
Coron Artery Dis. 2008 Dec;19(8):591-5. doi: 10.1097/MCA.0b013e32831381c8.
It has been reported that coronary endothelial dysfunction plays an important pathogenetic role in patients with slow coronary flow (SCF). Insulin resistance is defined as impairment of insulin-stimulated glucose and/or lipid metabolism, while endothelial dysfunction is defined as paradoxical or inadequate endothelial-mediated vasodilation. In this study, we aimed to evaluate insulin resistance in patients with SCF.
The study population included 25 patients with SCF and 28 healthy controls. Insulin resistance was estimated via homeostasis model assessment insulin resistance index (HOMA-IR).
Patients with SCF had higher high-sensitive C-reactive protein (hs-CRP) and HOMA-IR scores (P<0.05) than controls. Mean thrombolysis in myocardial infarction frame count had significant correlation with hs-CRP, fasting plasma insulin levels and HOMA-IR score (r=0.566, P<0.05; r=0.883, P<0.05; r=0.884, P<0.05, respectively).
In patients with SCF, thrombolysis in myocardial infarction frame counts and hs-CRP are correlated with increased insulin resistance and thus, it can be suggested that insulin resistance and inflammation may, in part, have a role in the pathogenesis of SCF.
据报道，冠状动脉内皮功能障碍在冠状动脉血流缓慢（SCF）患者的发病机制中起重要作用。胰岛素抵抗被定义为胰岛素刺激的葡萄糖和/或脂质代谢受损，而内皮功能障碍被定义为矛盾的或不足的内皮介导的血管舒张。在本研究中，我们旨在评估SCF患者的胰岛素抵抗情况。
研究人群包括25例SCF患者和28例健康对照者。通过稳态模型评估胰岛素抵抗指数（HOMA-IR）来估计胰岛素抵抗。
SCF患者的高敏C反应蛋白（hs-CRP）和HOMA-IR评分高于对照组（P<0.05）。心肌梗死帧数的平均溶栓时间与hs-CRP、空腹血浆胰岛素水平和HOMA-IR评分显著相关（r分别为0.566，P<0.05；r为0.883，P<0.05；r为0.884，P<0.05）。
在SCF患者中，心肌梗死帧数的溶栓时间和hs-CRP与胰岛素抵抗增加相关，因此，可以认为胰岛素抵抗和炎症可能在SCF的发病机制中起部分作用。
