Proinsulin is an independent predictor of the angiographical characteristics of coronary atherosclerosis

Objective: The objective of this survey was to study the association between circulating proinsulin level and the severity of coronary atherosclerosis. Methods: The study population consisted of 1,039 consecutive patients (775 males and 264 females) who underwent coronary angiography for suspected or known coronary atherosclerosis. The patients' anthropometric and plasma measurements including body mass index, blood pressure, blood lipid, blood glucose, and proinsulin level were performed. The severity of coronary atherosclerosis was defined by the Gensini's score system. Results: When proinsulin level was examined as a categorical variable classified by quartile values, subjects with a high proinsulin level had significantly higher values of Gensini's score than those with a low proinsulin level (p = 0.000). The Spearman correlation analysis suggests that the Gensini's score was significantly correlated with proinsulin level (r = -0.177, p = 0.000). Multiple stepwise linear regression analysis demonstrated that glucose (beta = 0.136, p = 0.000), age (beta = 0.189, p = 0.000), proinsulin (beta = 0.135, p = 0.000), SBP (mm Hg) (beta = -0.061, p = 0.043), fasting low-density lipoprotein cholesterol (mmol/l) (beta = 0.141, p = 0.003), and total cholesterol (beta = -0.105, p = 0.029) are significantly independently associated with the Gensini's score. Conclusions: Proinsulin is a strong and statistically highly significant predictor of coronary atherosclerosis independent of the other major risk factors including age, body mass index, blood pressure, fasting blood glucose, and blood lipid. The exact mechanisms need further study. Copyright (C) 2007 S. Karger AG, Basel.