Association of abdominal fat depots and insulin resistance in patients with coronary artery disease and metabolic syndrome

Aim. To evaluate the association between abdominal fat distribution and metabolic score of insulin resistance (IR) — Mets-IR, depending on the presence of metabolic syndrome (MS) in patients with stable coronary artery disease (CAD). Material and methods. Sixty-one patients with chronic CAD. The significance of coronary atherosclerosis was determined using the Gensini Score. MS was defined according to the International Diabetes Federation criteria (2005). Abdominal magnetic resonance imaging (MRI) was performed at the L4-L5 level to determine the volume of abdominal fat depots. Blood glucose and insulin levels, lipid profile parameters, and adipokines were determined. Insulin resistance was assessed by calculating the homeostatic model assessment of IR (HOMA-IR) and Mets-I R. Results. The MS group had significantly higher body mass indices and waist circumference, and between-group differences were found in glucose, serum leptin, and Mets-IR levels. In the MS group, abdominal subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) showed a strong correlation with Mets-I R. Patients with severe IR were characterized by increased VAT and SAT volumes; no difference in the VAT/SAT ratio was found. Body mass index, waist circumference, serum glucose, triglyceride, and high-sensitivity C-reactive protein levels were significantly higher, while high-density lipoprotein cholesterol levels were lower with greater IR severity. Conclusion. The relationship between IR and abdominal adipose tissue volume varies depending on the severity of IR and differs depending on the presence of metabolic syndrome. Among individuals with chronic coronary artery disease (CAD), abdominal visceral obesity is associated with metabolic syndrome. The use of Mets-IR has demonstrated its validity in assessing IR in patients with CAD and metabolic syndrome, as well as a strong association with magnetic resonance imaging (MRI) parameters of abdominal fat depot volume.