A novel numerical model of combination levels of C-peptide and insulin in coronary artery disease risk prediction

Hao Dai; Qi Fu; Heng Chen; Mei Zhang; Min Sun; Yong Gu; Ningtian Zhou; Tao Yang; Hao Dai; Qi Fu; Heng Chen; Mei Zhang; Min Sun; Yong Gu; Ningtian Zhou; Tao Yang

doi:10.3934/mbe.2021136

Mathematical Biosciences and Engineering

2021, Volume 18, Issue 3: 2675-2687. doi: 10.3934/mbe.2021136

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Research article Special Issues

A novel numerical model of combination levels of C-peptide and insulin in coronary artery disease risk prediction

Hao Dai ¹,
Qi Fu ¹,
Heng Chen ¹,
Mei Zhang ¹,
Min Sun ¹,
Yong Gu ¹,
Ningtian Zhou ^{2
,
,},
Tao Yang ^{1
,
,}

1.
Department of Endocrinology and Metabolism, the First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, Nanjing 210029, China
2.
Department of Cardiology, the First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, Nanjing 210029, China

Received: 31 January 2021 Accepted: 11 March 2021 Published: 19 March 2021

Objective
Insulin resistance is a major risk factor for coronary artery disease (CAD). The C-peptide-to-insulin ratio (C/I) is associated with hepatic insulin clearance and insulin resistance. The current study was designed to establish a novel C/I index (CPIRI) model and provide early risk assessment of CAD.
Methods
A total of 865 adults diagnosed with new-onset diabetes mellitus (DM) within one year and 54 healthy controls (HC) were recruited to develop a CPIRI model. The CPIRI model was established with fasting C/I as the independent variable and homeostasis model assessment of insulin resistance (HOMA-IR) as the dependent variable. Associations between the CPIRI model and the severity of CAD events were also assessed in 45 hyperglycemic patients with CAD documented via coronary arteriography (CAG) and whom underwent stress echocardiography (SE) and exercise electrocardiography test (EET).
Results
Fasting C-peptide/insulin and HOMA-IR were hyperbolically correlated in DM patients and HC, and log(C/I) and log(HOMA-IR) were linearly and negatively correlated. The respective correlational coefficients were −0.83 (p < 0.001) and −0.76 (p < 0.001). The equations CPIRI(DM) = 670/(C/I)^2.24 + 0.25 and CPIRI(HC) = 670/(C/I)^2.24 − 1 (F = 1904.39, p < 0.001) were obtained. Patients with insulin resistance exhibited severe coronary artery impairment and myocardial ischemia. In CAD patients there was no significant correlation between insulin resistance and the number of vessels involved.
Conclusions
CPIRI can be used to effectively evaluate insulin resistance, and the combination of CPIRI and non-invasive cardiovascular examination is of great clinical value in the assessment of CAD.
- coronary artery disease,
- C-peptide-to-insulin ratio index,
- exercise electrocardiography test,
- insulin resistance,
- stress echocardiography
Citation: Hao Dai, Qi Fu, Heng Chen, Mei Zhang, Min Sun, Yong Gu, Ningtian Zhou, Tao Yang. A novel numerical model of combination levels of C-peptide and insulin in coronary artery disease risk prediction[J]. Mathematical Biosciences and Engineering, 2021, 18(3): 2675-2687. doi: 10.3934/mbe.2021136

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Abstract

Objective

Insulin resistance is a major risk factor for coronary artery disease (CAD). The C-peptide-to-insulin ratio (C/I) is associated with hepatic insulin clearance and insulin resistance. The current study was designed to establish a novel C/I index (CPIRI) model and provide early risk assessment of CAD.

Methods

A total of 865 adults diagnosed with new-onset diabetes mellitus (DM) within one year and 54 healthy controls (HC) were recruited to develop a CPIRI model. The CPIRI model was established with fasting C/I as the independent variable and homeostasis model assessment of insulin resistance (HOMA-IR) as the dependent variable. Associations between the CPIRI model and the severity of CAD events were also assessed in 45 hyperglycemic patients with CAD documented via coronary arteriography (CAG) and whom underwent stress echocardiography (SE) and exercise electrocardiography test (EET).

Results

Fasting C-peptide/insulin and HOMA-IR were hyperbolically correlated in DM patients and HC, and log(C/I) and log(HOMA-IR) were linearly and negatively correlated. The respective correlational coefficients were −0.83 (p < 0.001) and −0.76 (p < 0.001). The equations CPIRI(DM) = 670/(C/I)^2.24 + 0.25 and CPIRI(HC) = 670/(C/I)^2.24 − 1 (F = 1904.39, p < 0.001) were obtained. Patients with insulin resistance exhibited severe coronary artery impairment and myocardial ischemia. In CAD patients there was no significant correlation between insulin resistance and the number of vessels involved.

Conclusions

CPIRI can be used to effectively evaluate insulin resistance, and the combination of CPIRI and non-invasive cardiovascular examination is of great clinical value in the assessment of CAD.

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