Factors Correlating with Severity of Coronary Artery Disease in Type 2 Diabetic Patients on Treatment for More Than 5 Years

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.