Post-challenge insulin concentration is useful for differentiating between coronary artery disease and cardiac syndrome X in subjects without known diabetes mellitus

Table 5 Binary logistic regression analysis of independent metabolic variables for diagnostic differentiation between coronary artery disease and cardiac syndrome X (status without known diabetes mellitus)

Factors	p value	OR	95% CI
Factors	p value	OR	Lower limit	Upper limit
Mode 1. Metabolic health and HOMA-IR index ^a, b
Age (years)	0.010	1.036	1.009	1.064
Gender (male vs. female)	<0.001	4.867	2.184	10.849
Body mass index (kg/m²)	0.449	1.036	0.946	1.135
Metabolically unhealthy (unhealthy vs. healthy)	0.004	2.680	1.380	5.204
HOMA-IR (mg/dl × µIU/ml)	0.554	1.022	0.950	1.099
Pre-admission statin use (with vs. without)	0.005	2.901	1.388	6.061
Mode 2. Metabolic health and OGTT 2 h glucose ^a, c
Age (years)	0.045	1.029	1.001	1.058
Gender (male vs. female)	<0.001	5.169	2.290	11.669
Body mass index (kg/m²)	0.336	1.043	0.958	1.135
Metabolically unhealthy (unhealthy vs. healthy)	0.014	2.368	1.194	4.696
OGTT 2 h glucose (mg/dl)	0.139	1.006	0.998	1.013
Pre-admission statin use (with vs. without)	0.004	3.037	1.436	6.423
Mode 3. Metabolic health and OGTT 2 h insulin ^a, d
Age (years)	0.012	1.036	1.008	1.065
Gender (male vs. female)	<0.001	6.544	2.763	15.502
Body mass index (kg/m²)	0.798	1.012	0.924	1.109
Metabolically unhealthy (unhealthy vs. healthy)	0.013	2.364	1.200	4.658
OGTT 2 h insulin (µIU/ml)	0.004	1.010	1.003	1.017
Pre-admission statin use (with vs. without)	0.005	2.939	1.381	2.657

Metabolically unhealthy: who met ≥2 of the following four criteria: high triglycerides (≥150 mg/dl) or took lipid-lowering drugs, elevated systolic blood pressure (≥130 mmHg) or diastolic blood pressure (≥85 mmHg) or took anti-hypertensive drugs, high fasting glucose (≥100 mg/dl) or took medications for diabetes (insulin or oral anti-diabetic), and low high-density lipoprotein cholesterol (<40 mg/dl for men and <50 mg/dl for women)
CI confidence interval, HOMA-IR homeostasis model assessment (HOMA) index of insulin-resistance = (fasting glucose mg/dl x fasting insulin μU/ml)/405, OGTT oral glucose tolerance test, OR odds ratio, pre-index statin use use of HMG-CoA reductase inhibitor before index admission
^aDependent variable: coronary artery disease vs. cardiac syndrome X
^bIndependent variables: demographic data, body mass index, metabolically unhealthy, statin use, and HOMA-IR
^cIndependent variables: demographic data, body mass index, metabolically unhealthy, statin use, and OGTT 2 h glucose
^dIndependent variables: demographic data, body mass index, metabolically unhealthy, statin use, and OGTT 2 h insulin

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