Internal Medicine Department, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Brazil.
Institute of Cardiology of Rio Grande do Sul/University Foundation of Cardiology, Porto Alegre, Brazil.
Diabetol Metab Syndr. 2010 Feb 3;2:11. doi: 10.1186/1758-5996-2-11.
Insulin-resistance is associated with cardiovascular disease but it is not used as a marker for disease in clinical practice.
To study the association between the homeostatic model assessment (HOMA-IR) and triglyceride/HDLc ratio (TG/HDLc) with the presence of coronary artery disease in patients submitted to cardiac catheterization.
In a cross-sectional study, 131 patients (57.0 +/- 10 years-old, 51.5% men) underwent clinical, laboratory and angiographic evaluation and were classified as No CAD (absence of coronary artery disease) or CAD (stenosis of more than 30% in at least one major coronary artery).
Prevalence of coronary artery disease was 56.7%. HOMA-IR and TG/HDLc index were higher in the CAD vs No CAD group, respectively: HOMA-IR: 3.19 (1.70-5.62) vs. 2.33 (1.44-4.06), p = 0.015 and TG/HDLc: 3.20 (2.38-5.59) vs. 2.80 (1.98-4.59) p = 0.045) - median (p25-75). After a ROC curve analysis, cut-off values were selected based on the best positive predictive value for each variable: HOMA-IR = 6.0, TG/HDLc = 8.5 and [HOMA-IRxTG/HDLc] = 28. Positive predictive value for coronary artery disease for HOMA-IR>6.0 was 82.6%, for TG/HDLc>8.5 was 85.7% and for [HOMA-IRxTG/HDLc]>28 was 88.0%. Adjusted relative risk (age, gender, diabetes, body mass index, systolic blood pressure) for the presence of coronary artery disease was: for HOMA-IR>6.0, 1.47 (95.CI: 1.06-2.04, p = 0.027), for TG/HDLc>8.5, 1.46 (95% CI:1.07-1.98), p = 0.015) and for [HOMA-IR x TG/HDLc] >28, 1.64 (95%CI: 1.28-2.09), p < 0.001).
Increased HOMA-IR, TG/HDLc and their product are positively associated with angiographic coronary artery disease, and may be useful for risk stratification as a high-specificity test for coronary artery disease.
胰岛素抵抗与心血管疾病相关，但在临床实践中并未将其作为疾病标志物。
研究稳态模型评估（HOMA-IR）和甘油三酯/高密度脂蛋白胆固醇比值（TG/HDLc）与接受心导管检查患者的冠状动脉疾病之间的相关性。
在一项横断面研究中，131 名患者（57.0±10 岁，51.5%为男性）接受了临床、实验室和血管造影评估，并分为无 CAD（无冠状动脉疾病）或 CAD（至少一条主要冠状动脉狭窄超过 30%）。
冠状动脉疾病的患病率为 56.7%。与无 CAD 组相比，CAD 组的 HOMA-IR 和 TG/HDLc 指数更高，分别为：HOMA-IR：3.19（1.70-5.62）vs. 2.33（1.44-4.06），p=0.015 和 TG/HDLc：3.20（2.38-5.59）vs. 2.80（1.98-4.59），p=0.045）-中位数（p25-75）。在 ROC 曲线分析后，根据每个变量的最佳阳性预测值选择截断值：HOMA-IR=6.0，TG/HDLc=8.5，[HOMA-IRxTG/HDLc]=28。HOMA-IR>6.0 对冠状动脉疾病的阳性预测值为 82.6%，TG/HDLc>8.5 的阳性预测值为 85.7%，[HOMA-IRxTG/HDLc]>28 的阳性预测值为 88.0%。调整年龄、性别、糖尿病、体重指数、收缩压等因素后，存在冠状动脉疾病的相对风险（HOMA-IR>6.0，1.47（95%CI：1.06-2.04，p=0.027），TG/HDLc>8.5，1.46（95%CI：1.07-1.98），p=0.015）和[HOMA-IRxTG/HDLc]>28，1.64（95%CI：1.28-2.09），p<0.001）。
HOMA-IR、TG/HDLc 及其乘积的增加与血管造影冠状动脉疾病呈正相关，可能作为一种高特异性的冠状动脉疾病检测方法用于风险分层。
