Articles Vol. 67 No. 2 02/03/2026

ASSOCIATION BETWEEN OVERWEIGHT-OBESITY AND INSULIN RESISTANCE IN PATIENTS WITH ACUTE CORONARY SYNDROME

Nguyen Ngoc Minh Thu1,2,3,4, Bui The Dung1,3,5,6, Lam Vinh Nien1,3,5,6, Nguyen Chi Thanh2,4
1 University of Medicine and Pharmacy at Ho Chi Minh city
2 Hong Bang International University
3 Đại học Y Dược thành phố Hồ Chí Minh
4 Trường Đại học Quốc tế Hồng Bàng
5 University Medical Center Ho Chi Minh City
6 Bệnh viện Đại học Y Dược thành phố Hồ Chí Minh
DOI: 10.52163/yhc.v67i2.4352
22 Views
11 Downloads
Keywords
Acute coronary syndrome, insulin resistance, HOMA2-IR, overweight, obesity.
Abstract

Objective: This study aimed to evaluate the association between overweight-obesity and insulin resistance in non-diabetic patients with acute coronary syndrome.

Methods: A cross-sectional study was conducted in 126 non-diabetic patients with acute coronary syndrome treated at the University Medical Center Ho Chi Minh City from June 2024 to April 2025. Insulin resistance was assessed using the HOMA2-IR index, with a cut-off value of ≥ 1.35. Overweight-obesity was defined based on BMI, using a cut-off of ≥ 23 kg/m² according to recommendations for Asian populations. Clinical and biochemical variables were analyzed for their associations with HOMA2-IR.

Results: Among 126 non-diabetic patients with acute coronary syndrome, the prevalence of overweight and obesity (BMI ≥ 23 kg/m²) was 44.4%. Patients with BMI ≥ 23 kg/m² exhibited significantly higher insulin levels and HOMA2-IR values, along with lower insulin sensitivity (HOMA2-%S), and more pronounced dyslipidemia. BMI was positively correlated with HOMA2-IR (r = 0.36; p < 0.001) and inversely correlated with HOMA2-%S (r = -0.34; p < 0.001). In multivariable regression analysis, BMI ≥ 23 kg/m² remained independently associated with increased HOMA2-IR (β = 0.79; p = 0.012).

Conclusion: In non-diabetic patients with metabolic syndrome, overweight and obesity (BMI ≥ 23 kg/m²) were independently and positively associated with insulin resistance as assessed by the HOMA2-IR. These findings highlight the role of excess body weight in early metabolic disturbances and suggest that greater attention to weight assessment and management may contribute to improving prognosis in this patient population.

References
[1]
Ray S, Bairagi A.K et al. A simple way to identify insulin resistance in non-diabetic acute coronary syndrome patients with impaired fasting glucose. Indian J Endocrinol Metab, 2012, 16 (Suppl 2): S460- S464. doi: 10.4103/2230-8210.104132 Google Scholar
[2]
Wallace T.M, Levy J.C, Matthews D.R. Use and abuse of HOMA modeling. Diabetes Care, 2004, 27 (6): 1487-95. doi: 10.2337/diacare.27.6.1487. Google Scholar
[3]
WHO Expert Consultation. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet, 2004, 363 (9403): 157-63. doi: 10.1016/S0140-6736(03)15268-3. Google Scholar
[4]
de Carvalho C.A, de Almeida Fonseca F.C. et al. The association between cardiovascular risk factors and anthropometric obesity indicators in university students in São Luís in the State of Maranhão, Brazil. Ciência & Saúde Coletiva, 2015, 20 (2): 479-90. doi: 10.1590/1413-81232015202.02342014. Google Scholar
[5]
Vu H.T.T, Pham H.M et al. Novel insights into clinical characteristics and in-hospital outcomes of patients undergoing percutaneous coronary intervention in Vietnam. Int J Cardiol Heart & Vasculature, 2020, 31: 100626. doi: 10.1016/j.ijcha.2020.100626. Google Scholar
[6]
Nguyen T.V, Le D et al. Frailty in older patients with acute coronary syndrome in Vietnam. Clin Interv Aging, 2019, 14: 2213-22. doi: 10.2147/CIA.S234597. Google Scholar
[7]
Banerjee R, Ray K et al. A study of insulin resistance and its clinico-metabolic associations among apparently healthy individuals attending a tertiary care hospital. Ann Med Health Sci Res, 2014, 4 (5): 823-8. doi: 10.4103/2141-9248.141572. Google Scholar
[8]
Yusuf S, Hawken S et al. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study. Lancet, 2004, 364 (9438): 937-52. doi: 10.1016/S0140-6736(04)17018-9. Google Scholar
[9]
Alejandro E.U, Gregg B et al. Natural history of β-cell adaptation and failure in type 2 diabetes. Mol Aspects Med, 2015, 42: 19-41. doi: 10.1016/j.mam.2014.12.002. Google Scholar
[10]
Yamada C, Moriyama K, Takahashi E. Association between insulin resistance and metabolic syndrome risk factors in Japanese. J Diabetes Investig, 2012, 3 (2): 185-190. doi: 10.1111/j.2040-1124.2011.00162.x. Google Scholar