Study on Features of Insulin Resistance in Patients with Coronary Heart Disease

Objective Researching the features of insulin resistance in patients with coronary heart disease (CHD) . Methods The study included 20 healthy subjects (control group), 53 CHD patients without (Group A) and 24 with essential hypertension (Group B) . Oral glucose tolerance test was administered to all subjects. Venous blood samples were taken during fasting and at 30, 60, 120 and 180 min after the glucose load (100g). All samples were assayed for glucose, insulin and C - peptide. Results The glucose, insulin, and C - peptide curves were at a hierarchy of Group B > Group A > the control group. Insulin - sensitivity - index was at an inverse hierarchy (-4. 31±0.55, -4. 05±0.47, - 3. 82±0. 42, respectively) . The ratio of the area under the C - peptide to the insulin was at a hierarchy of control group (3. 84±0. 81)> Group A (2. 84±0. 93)> Group B (2.26±0. 67), P < 0. 01) . As to insulin and C - peptide releasing types, most subjects of the control group had common type, while the predominant response type was pure - high in Group A, delayed - and delayed - high in Group B. Conclusions There are insulin resistance, insulin - C - peptide separation and changes of insulin and C - peptide releasing types in CHD patients. Insulin resistance is more severe when with hypertension. The hyperinsulinemia in CHD might be due to the over - secretion of insulin, also due to slow clearance in the patients accompanied by hypertension.

Effects of Aerobic Exercise Combined with Resistance Training on Patients with Myocardial Ischemia Caused by Coronary Heart Disease

Objective:To explore the clinical effect of long-term aerobic exercise combined with resistance training in patients with myocardial ischemia caused by coronary heart disease and its influence on cardiac function, exercise endurance and quality of life. Methods:100 patients with myocardial ischemia caused by coronary heart disease from January 2017 to January 2019 were randomly divided into control group (n = 50 cases) and observation group (n = 50 cases). The control group was given resistance training, while the observation group was combined with long-term aerobic exercise on the basis of the control group. The two groups were treated for 3 months. The cardiac function, exercise endurance and quality of life were compared between the two groups. Results:The levels of IVST (8.20+1.32) mm, LVDD (46.43+4.13) mm and LVSD (32.59+3.15) mm in the observation group were lower than those in the control group at 3 months after treatment. The level of LVEF (67.49+5.77)% in the observation group was higher than that in the control group at 3 months after treatment. The difference between the two groups was significant (P<0.05). The ET (55.42+2.9) in the observation group was higher than that in the control group (P<0.05). 2) The levels of ng/L and TXB2 (93.23 + 6.26) ng/L were significantly lower than those of the control group, and the difference between the two groups was statistically significant (P<0.05). The 6-minute walking distance (561.25 +43.64) m and the quality of life score (95.31 +6.39) in the observation group were higher than those in the control group 3 months after treatment, and the difference between the two groups was statistically significant (P<0.05). Conclusions:Long-term aerobic exercise combined with resistance training can improve cardiac function, exercise tolerance and quality of life in patients with myocardial ischemia caused by coronary heart disease, which is worthy of popularization and application.

The Study on the Correlation Between Plasma Adiponectin Level and Coronary Heart Disease

Objectives To investigate the relationship between plasma adiponectin level and coronary heart disease （CHD）, and some established cardiovascular risk factors and to probe its probable pathogenesis which adiponectin results in CHD. Methods The levels of plasma adiponectin, fasting plasma insulin （FINS）, C-reactive protein （CRP） and P-selectin were measured by ELISA, plasma ET-1 was measured by radioimmunoassay （RIA） in 75 male patients with CHD and 30 healthy male people. Body mass index （BMI）, waist / hip ratio （WHR） and insulin resistance index （Homa-IR） were calculated respectively. Results （1）The plasma adiponectin levels in CHD group were lower compared with control group[（5.18±2.57）mg / L vs（8.94±2.59）mg / L, P〈 0.001 ], there was no significant difference of plasma adiponectin levels in CHD sub-groups （P 〉 0.05）.（2） Based on multinominal stepwise logistic regression analysis, adiponectin was one of significant and independent risk factors for CHD. （3） Multivariate liner stepwise regression analysis showed that adiponectin had significant correlation with BMI and TG, BMI and TG were independent factors influencing on plasma adiponectin levels. （4） Pearson correlation analysis indicated plasma adiponectin levels were inversely related to FINS levels , Homa-IR, CRP, P-selectin and ET-1. Conclusions （ 1 ）Plasma adiponectin levels are lower in CHD patients compared the control subjects, there are no significant difference of plasma adiponectin levels in patients with SAP, UAP and AMI. （2） Plasma adiponectin levels are relative with CHD. Hypoadiponectinemia is an independent risk factor for CHD. （3）Established cardiovascular risk factors such as BMI and TG have an obvious influence on adiponectin. （4）The probable pathogenesis by which adiponectin involves in CHD is suggested that adiponectin relates to insulin resistance, inflammatory reaction and dysfunction of vessel endothelium.

ASSOCIATION OF INSULIN RESISTANCE AND C-REACTIVE PROTEIN WITH CORONARY ARTERY DISEASE IN PATIENTS WITH NORMAL GLUCOSE TOLERANCE

Objective To examine insulin resistance and high sensitivity C-reactive protein （hsCRP） association with clinical and angiographic severity of coronary artery disease （CAD） in patients with normal glucose tolerance. Methods In 638 consecutive patients with normal glucose tolerance, 221 had atypical chest pain and normal coronary artery （control group）, 279 had stable angina and CAD （SAP group ）, and 138 suffered acute myocardial infarction （ MI group）. The degree of CAD was further divided into borderline lesion （ lumen diameter narrowing 50% - 69% ）, significant 1-, 2- or 3-vessel disease （ luminal diameter narrowing 〉I 70% ）. Fasting serum glucose, insulin and hsCRP levels and lipid profiles were measured, and homeostasis model assessment for insulin resistance （ HOMA-IR ） was calculated. Multivariate analysis was performed to assess risk factors for 3-vessel disease or acute MI. Results Serum hsCRP, lipoprotein （a） levels, and insulin resistance index （IRI） were higher in AMI group than those in SAP and control groups. Serum hsCRP level and IRI were also higher in 3-vessel disease than those in other groups. Multivariate regression analysis revealed that insulin resistance, cigarette smoking, serum hsCRP, and lipoprotein （a） levels were independent risk factors for acute MI. Lipoprotein （ a ） elevation was an independent risk factor for 3-vessel disease. Conclusion Insulin resistance and high serum hsCRP level were associated with occurrence of acute MI and angiographic severity of coronary disease in patients with normal glucose tolerance.

Nonalcoholic fatty liver disease is associated with coronary artery disease in Koreans

AIM:To investigate whether nonalcoholic fatty liver disease(NAFLD)affects coronary artery disease(CAD)and identify candidate mediators.METHODS:Patients who underwent coronary angiography were consecutively recruited.The patients were classified into four groups by coronary artery stenosis:A,insignificant;B,one-vessel disease;C,two-vessel disease;and D,three-vessel disease.Abdominal ultrasonography was performed to determine the presence of a fatty liver and categorize by grade:0,no evidence;1,mild;2,moderate;and 3,severe.We measured not only known CAD risk factors,but also serum insulin,HOMA-index,adiponectin,interleukin-6,tumor necrosis factor-αand high-sensitivity C-reactive protein levels.RESULTS:Of the 134 patients who met the inclusion criteria,82(61.2%)had ultrasonographically diagnosed NAFLD.Among the 46 patients with CAD,37(80.4%)had evidence of a fatty liver.The two groups(A vs B-D)were significantly different in terms of age,total cholesterol,triglycerides,low-density lipoprotein levels and fatty liver.Coronary artery stenosis was strongly associated with fatty liver in a grade-dependent manner(P=0.025).In binary logistic regression,NAFLD was a significant independent predictor of CAD(P=0.03,OR=1.685;95%CI:1.051-2.702).Among the candidate mediators,the serum adiponectin level showed a trend toward lowering based on CAD progression(P=0.071).CONCLUSION:NAFLD is an independent risk factor for CAD in a grade-dependent manner.Moreover,adiponectin might be related to the pathogenesis of NAFLD.

NIDDM患者微量白蛋白尿与冠心病的关系

１０９例年龄≤６０岁的ＮＩＤＤＭ患者，其中４０例并有微量白蛋白尿或早期蛋白尿，６９例正常白蛋白尿，分析比较两组心血管疾病危险因素与心脏受损情况，结果发现微量白蛋白尿组与正常白蛋白尿组相比，缺血性心电图异常发生率较高（２５％比１５．９％），超声心动图左室舒张末期内径较大（４．８６±０．５４ｃｍ比４．６９±０．５５ｃｍ，Ｐ＜０．０５），表明微量白蛋白尿组有心脏受损较多的倾向，提示微量白蛋白尿是ＮＩＤＤＭ患者发生缺血性心脏病的危险信号。

Adiponectin Gene Variation -4522C/T Is Associated with Type 2 Diabetic Obesity and Insulin Resistance in Chinese

The authors investigated the possible association of -4522C/T variation of adiponectin gene with coronary heart disease （CHD） and type 2 diabetes mellitus （T2DM）. Genotyping of SNP --4522C/T in 304 patients with CHD, 389 patients with T2DM, and 405 age and sex-matched healthy control subjects was carried out by means of PCR-RFLP approach. No significant difference in the genotype or allele frequencies was found, either between patients with CHD and control subjects, or between patients with T2DM and control subjects. However, in the subgroup analysis, an association of the TAr genotype and T allele with type 2 diabetes combined with obesity （BMI ≥ 25 kg/m2） was found （P = 0.014 and P = 0.034, respectively）. Also the homeostasis model assessment of insulin resistance （HOMA-IR） in T2DM patients with T/T genotype was significantly higher than that in T2DM patients carrying C allele （P = 0.0069）. The authors＇ findings for the first time demonstrated that SNP --4522 in the adiponectin gene was associated with T2DM that combined with obesity and higher insulin resistance index in patients with T2DM. This indicated that the variation might associate with an increased susceptibility to type 2 diabetic obesity and insulin resistance. But -4522C/T polymorphism did not contribute to the susceptibility of CHD.

冠心病、NIDDM、高血压和尿毒症患者血脂质变化特点及意义

目的 观察冠心病、非胰岛素依赖性糖尿病 (NIDDM)、高血压和尿毒症患者的血脂质变化特点及其意义。方法 总胆固醇 (TC)测定采用CHOD PAP法 ,总甘油三酯 (TG)测定采用GPO POD法 ,高密度脂蛋白 (HDL)及高密度脂蛋白 2 (HDL2 )测定采用聚二乙醇 2 0 0 0法。结果 4种疾病患者血清的HDL2 都有十分明显的降低 ;冠心病、NIDDM、尿毒症患者HDL均降低明显 ;冠心病、NIDDM患者的TG明显升高 ;冠心病患者的TC显著升高、尿毒症患者的TC显著降低。结论 4种疾病患者存在不同程度脂质代谢紊乱 ,TC、TG、HDL、HDL2 在

NIDDM 患者并发冠心病的危险因素分析

目的初步探讨非胰岛素依赖性糖尿病（ＮＩＤＤＭ）患者并发冠心病的危险因素。方法将６５例ＮＩＤＤＭ患者分为无慢性并发症组和并发冠心病组，每组病人根据糖化血红蛋白水平又分为血糖控制较好组和血糖控制较差组，并设立正常对照组。分析各组病人ＨｂＡ１ｃ、血脂及血胰岛素水平及其与合并冠心病的关系。结果各糖尿病组患者普遍存在着脂代谢紊乱和高胰岛素血症，且以并发冠心病组最为明显。脂代谢紊乱主要表现为血甘油三酯、总胆固醇、低密度脂蛋白胆固醇和载脂蛋白Ｂ１００的升高，高密度脂蛋白胆固醇和载脂蛋白Ａ１的降低。血糖的控制有助于上述有关指标的改善。结论ＮＩＤＤＭ患者普遍存在着脂代谢紊乱和高胰岛素血症，此为ＮＩＤＤＭ患者并发冠心病的危险因素。

NIDDM患者冠心病与胰岛素抵抗之间关系的探讨

目的:探讨NIDDM病人冠心病与胰岛素抵抗之间的关系。方法:通过比较男性NIDDM合并CHD者与未合并CHD者的血糖、血胰岛素水平、胰岛素敏感指数(ISI)、血脂、细胞内Ca^(2+)和Mg^(2+)浓度,并对上述诸因素与CHD的关系进行多因素Logistic逐步回归分析。结果:NIDDM合并CHD者的体重指数(BMI)、甘油三酯(TG)、低密度脂蛋白(LDL)、空腹胰岛素浓度、ISI、Ca^(2+)、Mg^(2+)较未合并CHD组有统计学差异,ISI差异最为显著(P<0.001),同时发现,ISI与CHD发病呈显著负相关(OR=0.019,P=0.002)。结论:胰岛素抵抗(IR)可能是NIDDM合并CHD病人TG、LDL、Ca^(2+)浓度升高和HDL、细胞内Mg^(2+)浓度下降的重要原因之一。CHD是否继发于IR,以及是否可通过有效手段改善IR来降低CHD的发生,有待进一步探讨。

NIDDM和IGT患者血浆胰岛素水平及其相关疾病的研究

目的探讨血浆胰岛素水平与高血糖、高血压、高脂血症、肥胖及冠心病等疾病的关系。方法按空腹血浆胰岛素测定值高低分二组，比较二组间有关指标的差异。结果高胰岛素血症组收缩压、舒张压、甘油三脂、体重指数、腰臀比例均明显高于对照组（Ｐ＜０．０５～Ｐ＜０．００１）。结论高胰岛素血症组冠心病危险因素明显增高。

NIDDM患者血浆纤溶酶原激活物抑制剂-1(PAI-1)与并发冠心病关系的探讨

为明确血浆纤溶酶原激活物抑制剂－１（ＰＡＩ－１）在ＮＩＤＤＭ发生冠心病中所起的作用，并分析其影响因素。将６０例ＮＩＤＤＭ患者分为冠心病（ＣＡＤ）组和非ＣＡＤ组，用底物发光法检测血浆ＰＡＩ－１及组织型纤溶酶原（ｔ－ＰＡ），同时检测血糖、血胰岛素、血脂等指标。结果表明：ＣＡＤ组血浆ＰＡＩ－１活性水平明显高于非ＣＡＤ组，分别为１０．０６±２．５与８．０８±２．６２，单位Ａｕ／ｍｌ，Ｐ＜０．０１。两组ｔ－ＰＡ相似。在ＣＡＤ组，血浆ＰＡＩ－１活性与空腹胰岛素、胰岛素敏感指数均相关，相关系数分别为０．２４（Ｐ＜０．０５）与－０．３（Ｐ＜０．０１），且与甘油三酯呈正相关（ｒ＝０．２４，Ｐ＜０．０５），和ＡｐｏＢ正相关（ｒ＝０．５１，Ｐ＜０．０５）。血浆ＰＡＩ－１活性水平的升高与ＮＩＤ－ＤＭ发生ＣＡＤ危险性存在相关。胰岛素抵抗状态、高胰岛素血症、高ＴＧ水平都可刺激血浆ＰＡＩ－１活性的升高，而高血糖对其无直接的作用。ＡｐｏＢ参与ＰＡＩ－１活性改变这一过程，并在ＣＡＤ发生中可能介导其它脂质异常刺激ＰＡＩ－１升高的作用。

Association between Insulin Resistance and Metabolic Syndrome with Thyroid Status in Normal and Overweight/Obese Population: A Review

Background: Hypothyroidism has multiple etiologies and manifestation where accurate diagnosis and appropriate treatment is required and is in?uenced by coexisting medical conditions. This paper describes evidence-based clinical causes and indications. Objective: The objective is to review the clinical effect of hypothyroidism in different selected aspects and summarize the potential evidence about relationship between subclinical hypothyroidism with cardiovascular disease, diabetes mellitus, insulin resistance and mortality. Data Sources: A systematic review was conducted by searching English-language articles identified from 23 databases and search engines, yielding over 1000 documents. Study Selection: They are reports on the effects of hypothyroidism versus euthyroidism on obesity, insulin resistance, cardiovascular disease, coronary heart disease and mortality. Data Extraction: Data from research articles on hypothyroidism including subclinical hypothyroidism (SCH) and overt hypothyroidism, insulin resistance including diabetes mellitus and risk for coronary heart disease (CHD) including metabolic syndrome were independently assessed and summarized. Data Synthesis: Twelve of twenty-nine identified studies involved population-based cohorts, case controls and retrospective studies that included 4306 subjects. All 13 studies examined risks associated with subclinical hypothyroidism with type 2 diabetes mellitus (T2DM) and prevalence rates of SCH in T2DM patients ranged from 4.69% to 64.28% in the 12 included studies. Moreover, 4 studies out of the above 12 studies have revealed insulin resistance in the participants. Another population-based 12 studies have been carried out to assess hypothyroidism-related cardiac manifestation and according to the given data, average prevalence of CHD in hypothyroid participants is 25.20 (vary from 3.73 to 47.14) and it is 13.90 in euthyroid participants (vary from 1.17 to 38.49). Conclusions: Type 2 diabetes mellitus people are more likely to get subclinical hypothyroidism and subclinical hypothyroid population also shows several complications associated with type 2 diabetes mellitus. Besides, subclinical thyroid dysfunction might represent a risk factor for coronary artery disease and mortality.

Coronary physiology assessment in the catheterization laboratory

Physicians cannot rely solely on the angiographic appearance of epicardial coronary artery stenosis when evaluating patients with myocardial ischemia. Instead, sound knowledge of coronary vascular physiology and of the methods currently available for its characterization can improve the diagnostic and prognostic accuracy of invasive assessment of the coronary circulation, and help improve clinical decision-making. In this article we summarize the current methods available for a thorough assessment of coronary physiology.

Hypothesis:Intensive insulin therapy-induced mortality is due to excessive serotonin autoinhibition and autonomic dysregulation

Action to Control Cardiovascular Risk in Diabetes(ACCORD),The Action in Diabetes and Vascular Disease:Preterax and Diamicron Modified Release Controlled Evaluation and the Veterans Affairs Diabetes Trial were designed to study whether older patients with type 2 diabetes mellitus could reduce the risk of heart attacks and stroke and thereby prolong their lives by maintaining their blood glucose levels at near-healthy levels but failed to demonstrate the hoped-for benef it.Why the trials failed,though,and why ACCORD saw significantly more deaths due to increased rates of cardiovascular events in the intensive therapy arm of the study are not clear.These data have now been confirmed by the results of the recently concluded NICE-SUGAR Study which again revealed that intensive gluc ose control increased mortality among adults in intensive care units.I propose that the negative results noted in these trials are due to altered brain serot o nin concentrations and autonomic dysregulation in addition to the low-grade systemic inflammation,decreased endothelial nitric oxide and enhanced free radical generation,diminished anti-oxidant defenses and altered metabol ism of essential fatty acids present in patients with type 2 diabetes.

Myocardial insulin resistance does not always parallel skeletal muscle and whole body insulin resistance: A mini review<br>—Myocardial Insulin Resistance <br>

Insulin resistance (IR) is recognized to be of critical importance in a variety of metabolic diseases and coronary artery disease (CAD). Impaired skeletal muscle glucose utilization (SMGU) plays an important role in the pathogenesis of IR, whereas it is controversial whether myocardial IR is similar in this respect. Methods: Twenty-two studies of myocardial IR and skeletal muscle IR using positron emission tomography (PET) and/or whole body IR were reviewed. Heart and skeletal muscle IR were measured with PET and18F-FDG under hyperinsulinemic euglycemic insulin clamp technique. Whole body IR was also determined at the time of PET under hyperinsulinemic euglycemic insulin clamp technique. Results: One study reported that heart and skeletal muscle IR is present in untreated type 2 diabetes mellitus (T2DM), hypertension and CAD (as reflected in a myocardial glucose utiliation rate (MGU) in T2DM vs control [p -0.665, p -0.60, p -0.74, p -0.74, p 18F-FDG Uptake (MFU) in hypertriglyc-eridemics was (p = ns) despite findings of reduced skeletal muscle18F-FDG uptake (SMFU in hyper-triglyceridemia

利拉鲁肽治疗冠心病合并2型糖尿病患者的临床研究

目的 分析利拉鲁肽治疗冠心病合并2型糖尿病患者的临床效果。方法 102例冠心病合并2型糖尿病患者,应用电脑随机选择方式将患者分为对照组和观察组,每组51例。对照组给予二甲双胍治疗,观察组给予二甲双胍结合利拉鲁肽治疗。对比两组心功能指标(左室射血分数、左室舒张末内径、心排血量以及QT离散度)、血糖指标[空腹血糖(FPG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(HbA1c)]、胰岛素抵抗情况[胰岛β细胞功能指数(HOMA-β)、胰岛素抵抗指数(HOMA-IR)]。结果 治疗后,观察组左室射血分数(56.10±9.06)%、左室舒张末内径(45.80±6.64)mm、心排血量(5.60±1.18)L/min、QT离散度(45.03±6.31)ms优于对照组的(50.50±7.90)%、(50.20±7.07)mm、(4.88±1.01)L/min、(53.77±8.50)ms(P<0.05)。治疗后,观察组2 h PG(7.28±1.30)mmol/L、FPG(6.06±0.27)mmol/L、HbA1c(5.88±0.32)%优于对照组的(8.71±1.20)mmol/L、(7.01±0.76)mmol/L、(6.65±0.52)%(P<0.05)。治疗后,观察组HOMA-β、HOMA-IR优于对照组(P<0.05)。结论 结合冠心病合并2型糖尿病患者实际情况应用二甲双胍结合利拉鲁肽治疗,能够有效改善患者的心功能指标、血糖指标及胰岛素抵抗情况,具有优良的应用前景,在今后的工作过程中能够进一步应用。

CTCA定量参数对冠心病患者短期病死预测价值

目的探讨CT冠状动脉造影(CTCA)定量参数对冠心病患者短期病死预测价值。方法选取2021年3月—2023年3月收治的冠心病200例,比较不同冠状动脉病变程度冠心病患者CTCA定量参数(动脉阻力指数、总斑块负荷和斑块最小密度CT值),分析CTCA定量参数与冠心病患者冠状动脉病变程度相关性,探讨术后1年冠心病患者病死情况,分析CTCA定量参数与冠心病患者短期病死风险关联性,评价CTCA定量参数对冠心病患者短期病死预测价值。结果不同冠状动脉病变程度冠心病患者动脉阻力指数、总斑块负荷逐渐升高,斑块最小密度CT值逐渐降低(P<0.05)。冠心病患者动脉阻力指数、总斑块负荷与疾病类型、病变支数及狭窄程度呈正相关,斑块最小密度CT值与疾病类型、病变支数及狭窄程度呈负相关(P<0.05)。冠心病200例中39例(19.50%)术后1年病死。动脉阻力指数、总斑块负荷和斑块最小密度CT值与冠心病患者短期病死有关(P<0.01)。对冠心病患者短期病死预测的受试者工作特征曲线下面积动脉阻力指数、总斑块负荷和斑块最小密度CT值三者联合明显高于单独预测(P<0.05)。结论CTCA定量参数与冠心病患者冠状动脉病变程度密切相关,且联合各参数预测冠心病患者短期病死价值较高。

T2DM合并冠心病介入治疗术后患者应用胰岛素泵强化降糖疗法的作用价值

目的探究胰岛素泵强化降糖疗法应用于2型糖尿病(type 2 diabetes mellitus,T2DM)合并冠状动脉粥样硬化性心脏病(简称冠心病)介入治疗术后的效果。方法回顾性选取2023年1—12月在四川大学华西厦门医院(研究院)就诊的130例T2DM合并冠心病患者的临床资料,全部患者均选择冠心病介入术治疗,按照术后选用的降糖疗法不同分为对照组(常规胰岛素注射)和研究组(胰岛素泵强化降糖),各65例。比较两组血脂及血糖水平(糖化血红蛋白、餐后2 h血糖、空腹血糖、总胆固醇、甘油三酯)、胰岛功能(胰岛β细胞功能指数、胰岛素抵抗指数)情况。结果治疗前两组血糖、血脂及胰岛功能对比,差异无统计学意义(P均>0.05)。治疗2周后,研究组血糖及血脂指标均低于对照组,差异有统计学意义(P均<0.05)。治疗2周后,与对照组比较,研究组胰岛β细胞功能指数更高,胰岛素抵抗指数更低,差异有统计学意义(P均<0.05)。结论接受介入术的T2DM合并冠心病患者术后降糖中选择胰岛素泵,能够改善患者血脂及血糖水平,提高胰岛功能。

Insulin sensitivity and the diffuseness of coronary artery disease in humans

OBJECTIVE: To study the relationship between insulin sensitivity and diffuse coronary artery disease. METHODS: Ninety-two consecutive patients underwent coronary angiography were enrolled in the study. Relationships between the results of angiograms and both glucose tolerance and blood lipids were analyzed. RESULTS: The mean age of the 92 patients (70 males, 22 females) was 65.4 +/- 6.3 y. In the 78 patients diagnosed by angiography as coronary artery disease, diffuse lesion was more common in diabetic patients than in those without a diabetes history (12/13 vs 24/65, P = 0.00026). Fasting glucose [(6.06 +/- 2.43) x 10(-3) mol/L vs (4.80 +/- 1.47) x 10(-3) mol/L, P = 0.009], glucose levels at one hour [(12.37 +/- 4.38) x 10(-3) mol/L vs (9.10 +/- 3.97) x 10(-3) mol/L, P = 0.001], two hours [(11.12 +/- 5.64) x 10(-3) mol/L vs (7.49 +/- 4.29) x 10(-3) mol/L, P = 0.003] and three hours [(8.11 +/- 5.51) x 10(-3) mol/L vs (5.56 +/- 3.46) x 10(-3) mol/L, P = 0.020] after food were higher in patients with diffuse coronary disease than in those with non-diffuse coronary disease. Differences in the insulin sensitivity index (ISI) between the two groups was statistically significant (-4.36 +/- 0.52 vs -3.89 +/- 0.69, P = 0.003). The incidence of multiple-vessel disease in diabetic patients was higher than that in non-diabetic patients (12/13 vs 33/65, P = 0.00565). Glucose levels at two hours [(10.22 +/- 5.57) x 10(-3) mol/L vs (7.67 +/- 4.43) x 10(-3) mol/L, P = 0.034] and three hours [(7.90 +/- 5.47) x 10(-3) mol/L vs (5.22 +/- 2.79) x 10(-3) mol/L, P = 0.007] after food were higher in patients with multiple-vessel disease than in those with single-vessel disease. Impaired insulin sensitivity without a history of diabetes mellitus was commonly seen in patients with coronary artery disease. CONCLUSIONS: The diffuseness of coronary artery disease is associated with insulin sensitivity and blood glucose levels. Insulin resistance is a common phenomenon in non-diabetic patients.