HOMA estimated insulin resistance as a marker for angiographic severity of coronary artery disease in non-diabetic and non-obese patients

Insulin resistance (IR) examined by homeostasis model assessment of insulin resistance (HOMA-IR) measures increased carotid atherosclerosis risks in non-diabetic and non-obese persons. The information about the relationship between IR and coronary atherosclerosis severity among non-diabetic and non- obese population showed conflicting results. The goal of the current study was to assess the relationship that links IR and coronary artery disease (CAD) among non-diabetic and non-obese Egyptian populations.

112 non-diabetic and non-obese patients were included in this study. These patients underwent coronary angiogram (CA) either due to acute coronary syndrome (ACS) or chronic stable angina with positive exercise tests.

Our study found a strong association between HOMA-IR and Gensini score (r = 0.831, with p<0.001) in general population. The HOMA-IR was the most influential independent predictor for the presence of extensive coronary atherosclerosis. Non-diabetic and non-obese people carrying the risk of developing the three-vessel disease (3VD) may be identified with a HOMA-IR score of over 5.9 according to the ROC curve analysis with a sensitivity of 67.7%.

IR that developes in non-diabetic non-obese individuals coincides with more severe and more outspread CAD. In non-diabetic non-obese populations who need a CA, a single HOMA-IR value is higher than 5.9 may imply an elevated risk for clinically significant CAD. As insulin resistance is a reversible process, risk stratifications of CAD in non-diabetic non-obese populations could include HOMA-IR as one of its parameters.