Objective To explore the heterogeneity of insulin sensitivity (IS) and the distribution of cardiovascular risk factors in the races of the Uygur and Han patients with coronary heart diseases (CHD) in Urumqi. Methods A total of 164 CHD patients (50 Uygurs and 114 Hans) hospitalized in the Autonomous Regional Hospital from 2001 to 2002 were recruited in this study. Another 71 healthy individuals (35 Uygurs and 36 Hans) served as normal controls. Oral glucose tolerance test (OGTT) and insulin release test were used to measure the concentrations of blood glucose and insulin before and after oral 75 g glucose in 0, 0.5, 1, 2 and 3h. The Homeostasis Model Assessment of Insulin Sensitivity (HOMA IS) was calculated by the HOMA model. Results The IS was significantly lower in the CHD patients than in the normal controls [the Uygurs: (204.02±180.43) vs (409.14±181.06); the Hans: (258.09±105.66) vs (479.09±200.97); P＜0.05]. The CHD patients also had higher morbidities of metabolic syndrome (the Uygurs: 54% vs 25.7%; the Hans: 66.7% vs 22.7%; P＜0.05) and of diabetes mellitus (the Uygurs: 52.0% vs 0.0%; the Hans: 64.0% vs 0.0%, P＜0.01) when compared with the normal controls. The CHD patients had significantly decreased 1h insulin and increased 2h glucose than the normal controls (P＜0.05). No significant difference was found in other indices between the CHD patients and normal controls. There was no difference in the morbidity of metabolic syndrome and IS between the 2 ethnics no matter for CHD patients or the normal controls. Significant differences were seen in the body mass [(78.06±12.69) vs (72.32±12.03)kg, P＜0.01] and body mass index [BMI(27.29±3.53) vs (25.61±3.42)kg/m2, P＜0.01] in the two ethnic patients with CHD. But no such difference was seen in the normal controls. Logistic regression analysis showed that alcohol drinking (OR=2.532), diabetes mellitus (OR=2.466), and hypertension (OR=2.355) had positive correlation with CHD (P＜0.05), and high-density lipoprotein cholesterol had negative correlation with CHD (P＜0.05). Conclusion Both Uygur and Han CHD patients in Urumqi have lower IS and higher morbidity of metabolic syndrome and diabetes mellitus. The Uygur CHD patients have higher prevalence of obesity. Alcohol drinking, diabetes mellitus, and hypertension are risk factors of CHD in the two ethnics in the Xinjiang Uygur Autonomous Region.