Abnormal Glucose Regulation Is Associated With Lipid-Rich Coronary Plaque. Relationship to Insulin Resistance

Tetsuya Amano, Tatsuaki Matsubara, Tadayuki Uetani, Michio Nanki, Nobuyuki Marui, Masataka Kato, Tomohiro Yoshida, Kosuke Arai, Kiminobu Yokoi, Hirohiko Ando, Soichiro Kumagai, Hideki Ishii, Hideo Izawa, Nigishi Hotta, Toyoaki Murohara

Research output: Contribution to journalArticle

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Abstract

Objectives: This study sought to determine lipid and fibrous volume of coronary atherosclerotic plaques in subjects with abnormal glucose regulation (AGR) by integrated backscatter (IB) intravascular ultrasound (IVUS) during percutaneous coronary intervention. Background: Abnormal glucose regulation, including impaired glucose regulation (IGR) and diabetes mellitus (DM), has emerged as an important determinant of cardiovascular risk. We hypothesized that AGR would be associated with coronary plaque instability. Methods: Conventional intravascular ultrasound and IB-IVUS using a 40-MHz (motorized pullback 1 mm/s) intravascular catheter was performed in 172 consecutive patients. The percentage of fibrous area and the percentage of lipid area were automatically calculated by IB-IVUS. Three-dimensional analysis of IB-IVUS images was performed to determine the percentage of lipid volume (%LV) and fibrous volume (%FV). Following the World Health Organization criteria, the subjects were classified into the DM group, the IGR group, and the normal glucose regulation group. The cutoff point for the lipid-rich plaque was defined as %LV >44% or %FV <52%, which was the 75th percentile of %LV or the 25th percentile of %FV in this study population. Insulin resistance (IR) was defined as the homeostasis model assessment of insulin resistance (HOMA-IR). Results: There were no significant differences in the baseline characteristics except for glucometabolic parameters. The conventional IVUS analysis indicated that the DM group had a significantly increased plaque volume (and percent plaque volume). In the IB-IVUS analysis, as compared with the normal glucose regulation group, the DM and the IGR groups showed a significant increase in %LV (36 ± 14% and 37 ± 13% vs. 29 ± 14%, p = 0.02) and a significant decrease in %FV (59 ± 11% and 58 ± 11% vs. 64 ± 11%, p = 0.03). The lipid-rich plaque rate was significantly associated with an increasing HOMA-IR in the tertile (p = 0.008). On logistic regression analysis after adjusting for confounding and coronary risk factors, the DM group (odds ratio 3.52, 95% confidence interval 1.13 to 11.0, p = 0.03) and the IGR group (odds ratio 3.92, 95% confidence interval 1.13 to 13.6, p = 0.03) were significantly associated with the lipid-rich plaque. Conclusions: Coronary lesions in patients with AGR are associated with more lipid-rich plaque content, which may be related to the increased IR in these patients.

Original languageEnglish
Pages (from-to)39-45
Number of pages7
JournalJACC: Cardiovascular Imaging
Volume1
Issue number1
DOIs
Publication statusPublished - 01-01-2008
Externally publishedYes

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Insulin Resistance
Lipids
Glucose
Diabetes Mellitus
Homeostasis
Odds Ratio
Confidence Intervals
Atherosclerotic Plaques
Percutaneous Coronary Intervention
Catheters
Logistic Models
Regression Analysis
Population

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Amano, Tetsuya ; Matsubara, Tatsuaki ; Uetani, Tadayuki ; Nanki, Michio ; Marui, Nobuyuki ; Kato, Masataka ; Yoshida, Tomohiro ; Arai, Kosuke ; Yokoi, Kiminobu ; Ando, Hirohiko ; Kumagai, Soichiro ; Ishii, Hideki ; Izawa, Hideo ; Hotta, Nigishi ; Murohara, Toyoaki. / Abnormal Glucose Regulation Is Associated With Lipid-Rich Coronary Plaque. Relationship to Insulin Resistance. In: JACC: Cardiovascular Imaging. 2008 ; Vol. 1, No. 1. pp. 39-45.
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abstract = "Objectives: This study sought to determine lipid and fibrous volume of coronary atherosclerotic plaques in subjects with abnormal glucose regulation (AGR) by integrated backscatter (IB) intravascular ultrasound (IVUS) during percutaneous coronary intervention. Background: Abnormal glucose regulation, including impaired glucose regulation (IGR) and diabetes mellitus (DM), has emerged as an important determinant of cardiovascular risk. We hypothesized that AGR would be associated with coronary plaque instability. Methods: Conventional intravascular ultrasound and IB-IVUS using a 40-MHz (motorized pullback 1 mm/s) intravascular catheter was performed in 172 consecutive patients. The percentage of fibrous area and the percentage of lipid area were automatically calculated by IB-IVUS. Three-dimensional analysis of IB-IVUS images was performed to determine the percentage of lipid volume ({\%}LV) and fibrous volume ({\%}FV). Following the World Health Organization criteria, the subjects were classified into the DM group, the IGR group, and the normal glucose regulation group. The cutoff point for the lipid-rich plaque was defined as {\%}LV >44{\%} or {\%}FV <52{\%}, which was the 75th percentile of {\%}LV or the 25th percentile of {\%}FV in this study population. Insulin resistance (IR) was defined as the homeostasis model assessment of insulin resistance (HOMA-IR). Results: There were no significant differences in the baseline characteristics except for glucometabolic parameters. The conventional IVUS analysis indicated that the DM group had a significantly increased plaque volume (and percent plaque volume). In the IB-IVUS analysis, as compared with the normal glucose regulation group, the DM and the IGR groups showed a significant increase in {\%}LV (36 ± 14{\%} and 37 ± 13{\%} vs. 29 ± 14{\%}, p = 0.02) and a significant decrease in {\%}FV (59 ± 11{\%} and 58 ± 11{\%} vs. 64 ± 11{\%}, p = 0.03). The lipid-rich plaque rate was significantly associated with an increasing HOMA-IR in the tertile (p = 0.008). On logistic regression analysis after adjusting for confounding and coronary risk factors, the DM group (odds ratio 3.52, 95{\%} confidence interval 1.13 to 11.0, p = 0.03) and the IGR group (odds ratio 3.92, 95{\%} confidence interval 1.13 to 13.6, p = 0.03) were significantly associated with the lipid-rich plaque. Conclusions: Coronary lesions in patients with AGR are associated with more lipid-rich plaque content, which may be related to the increased IR in these patients.",
author = "Tetsuya Amano and Tatsuaki Matsubara and Tadayuki Uetani and Michio Nanki and Nobuyuki Marui and Masataka Kato and Tomohiro Yoshida and Kosuke Arai and Kiminobu Yokoi and Hirohiko Ando and Soichiro Kumagai and Hideki Ishii and Hideo Izawa and Nigishi Hotta and Toyoaki Murohara",
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Amano, T, Matsubara, T, Uetani, T, Nanki, M, Marui, N, Kato, M, Yoshida, T, Arai, K, Yokoi, K, Ando, H, Kumagai, S, Ishii, H, Izawa, H, Hotta, N & Murohara, T 2008, 'Abnormal Glucose Regulation Is Associated With Lipid-Rich Coronary Plaque. Relationship to Insulin Resistance', JACC: Cardiovascular Imaging, vol. 1, no. 1, pp. 39-45. https://doi.org/10.1016/j.jcmg.2007.09.003

Abnormal Glucose Regulation Is Associated With Lipid-Rich Coronary Plaque. Relationship to Insulin Resistance. / Amano, Tetsuya; Matsubara, Tatsuaki; Uetani, Tadayuki; Nanki, Michio; Marui, Nobuyuki; Kato, Masataka; Yoshida, Tomohiro; Arai, Kosuke; Yokoi, Kiminobu; Ando, Hirohiko; Kumagai, Soichiro; Ishii, Hideki; Izawa, Hideo; Hotta, Nigishi; Murohara, Toyoaki.

In: JACC: Cardiovascular Imaging, Vol. 1, No. 1, 01.01.2008, p. 39-45.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Abnormal Glucose Regulation Is Associated With Lipid-Rich Coronary Plaque. Relationship to Insulin Resistance

AU - Amano, Tetsuya

AU - Matsubara, Tatsuaki

AU - Uetani, Tadayuki

AU - Nanki, Michio

AU - Marui, Nobuyuki

AU - Kato, Masataka

AU - Yoshida, Tomohiro

AU - Arai, Kosuke

AU - Yokoi, Kiminobu

AU - Ando, Hirohiko

AU - Kumagai, Soichiro

AU - Ishii, Hideki

AU - Izawa, Hideo

AU - Hotta, Nigishi

AU - Murohara, Toyoaki

PY - 2008/1/1

Y1 - 2008/1/1

N2 - Objectives: This study sought to determine lipid and fibrous volume of coronary atherosclerotic plaques in subjects with abnormal glucose regulation (AGR) by integrated backscatter (IB) intravascular ultrasound (IVUS) during percutaneous coronary intervention. Background: Abnormal glucose regulation, including impaired glucose regulation (IGR) and diabetes mellitus (DM), has emerged as an important determinant of cardiovascular risk. We hypothesized that AGR would be associated with coronary plaque instability. Methods: Conventional intravascular ultrasound and IB-IVUS using a 40-MHz (motorized pullback 1 mm/s) intravascular catheter was performed in 172 consecutive patients. The percentage of fibrous area and the percentage of lipid area were automatically calculated by IB-IVUS. Three-dimensional analysis of IB-IVUS images was performed to determine the percentage of lipid volume (%LV) and fibrous volume (%FV). Following the World Health Organization criteria, the subjects were classified into the DM group, the IGR group, and the normal glucose regulation group. The cutoff point for the lipid-rich plaque was defined as %LV >44% or %FV <52%, which was the 75th percentile of %LV or the 25th percentile of %FV in this study population. Insulin resistance (IR) was defined as the homeostasis model assessment of insulin resistance (HOMA-IR). Results: There were no significant differences in the baseline characteristics except for glucometabolic parameters. The conventional IVUS analysis indicated that the DM group had a significantly increased plaque volume (and percent plaque volume). In the IB-IVUS analysis, as compared with the normal glucose regulation group, the DM and the IGR groups showed a significant increase in %LV (36 ± 14% and 37 ± 13% vs. 29 ± 14%, p = 0.02) and a significant decrease in %FV (59 ± 11% and 58 ± 11% vs. 64 ± 11%, p = 0.03). The lipid-rich plaque rate was significantly associated with an increasing HOMA-IR in the tertile (p = 0.008). On logistic regression analysis after adjusting for confounding and coronary risk factors, the DM group (odds ratio 3.52, 95% confidence interval 1.13 to 11.0, p = 0.03) and the IGR group (odds ratio 3.92, 95% confidence interval 1.13 to 13.6, p = 0.03) were significantly associated with the lipid-rich plaque. Conclusions: Coronary lesions in patients with AGR are associated with more lipid-rich plaque content, which may be related to the increased IR in these patients.

AB - Objectives: This study sought to determine lipid and fibrous volume of coronary atherosclerotic plaques in subjects with abnormal glucose regulation (AGR) by integrated backscatter (IB) intravascular ultrasound (IVUS) during percutaneous coronary intervention. Background: Abnormal glucose regulation, including impaired glucose regulation (IGR) and diabetes mellitus (DM), has emerged as an important determinant of cardiovascular risk. We hypothesized that AGR would be associated with coronary plaque instability. Methods: Conventional intravascular ultrasound and IB-IVUS using a 40-MHz (motorized pullback 1 mm/s) intravascular catheter was performed in 172 consecutive patients. The percentage of fibrous area and the percentage of lipid area were automatically calculated by IB-IVUS. Three-dimensional analysis of IB-IVUS images was performed to determine the percentage of lipid volume (%LV) and fibrous volume (%FV). Following the World Health Organization criteria, the subjects were classified into the DM group, the IGR group, and the normal glucose regulation group. The cutoff point for the lipid-rich plaque was defined as %LV >44% or %FV <52%, which was the 75th percentile of %LV or the 25th percentile of %FV in this study population. Insulin resistance (IR) was defined as the homeostasis model assessment of insulin resistance (HOMA-IR). Results: There were no significant differences in the baseline characteristics except for glucometabolic parameters. The conventional IVUS analysis indicated that the DM group had a significantly increased plaque volume (and percent plaque volume). In the IB-IVUS analysis, as compared with the normal glucose regulation group, the DM and the IGR groups showed a significant increase in %LV (36 ± 14% and 37 ± 13% vs. 29 ± 14%, p = 0.02) and a significant decrease in %FV (59 ± 11% and 58 ± 11% vs. 64 ± 11%, p = 0.03). The lipid-rich plaque rate was significantly associated with an increasing HOMA-IR in the tertile (p = 0.008). On logistic regression analysis after adjusting for confounding and coronary risk factors, the DM group (odds ratio 3.52, 95% confidence interval 1.13 to 11.0, p = 0.03) and the IGR group (odds ratio 3.92, 95% confidence interval 1.13 to 13.6, p = 0.03) were significantly associated with the lipid-rich plaque. Conclusions: Coronary lesions in patients with AGR are associated with more lipid-rich plaque content, which may be related to the increased IR in these patients.

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