A Study on Insulin Resistance and the Relationship of TG/HDL Cholesterol Index and HSCRP with Coronary Heart Disease

Abstract

Background: Coronary heart disease is a multifactorial disease. It has been appreciated for a long time that a number a cardiovascular risk factors tend to cluster in the same individuals. The risk factors are insulin resistance, hyperinsulinemia, hyperglycemia, dyslipidemia (high triglycerides and low HDL cholesterol), hypertension, smoking and T2DM. Insulin resistance is the main underlying metabolic deterioration in CHD. A significant body of evidence now supports an association between insulin resistance and endothelial dysfunction, an important early event in the development of atherosclerosis.Aim & Objectives: The present study was designed to assess the relationship between Insulin resistance measured by HOMA-IR, Dyslipidemia consisting of high triglycerides and low HDL cholesterol and HSCRP an emerging inflammatory bio marker in Coronary heart disease.Methodology: A case control study was conducted in the Department of Biochemistry, Osmania General Hospital, Hyderabad during December 2013 to May 2015.Results: In this study significant increase in Mean ± S.D of IR was seen in high risk individuals without CHD and in CHD cases when compared to controls. There was no significant decrease in high risk individuals and CHD cases implicating its strength as a predictor of CHD. Mean ± S.D of TG/HDL index levels were significantly increased in high risk individuals without CHD cases and in CHD cases. There is strong evidence that both high TG and a low HDL-C are a frequent consequence of IR and TG/HDL index can be used as a marker for insulin resistance. In the present study Increased HOMA-IR, TG/HDLc and HS CRP are positively associated with coronary heart disease. There is positive correlation with statistical significance among all the three parameters in CHD cases. Our present study provides clear evidence that for the end points of MI and CHD death, the risk associated with lower and higher levels of HDL-C and triglycerides can be more precisely defined in conjunction with a measure of IR. Conclusion: The combination of these evaluated markers has the potential to serve as a screening tool for cardiovascular risk assessment and clinical management. We believe that this simple and non-invasive set of tests may be a useful in optimizing the selection of patients to proceed to a more invasive investigation.