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The comparison of coronary angiographic profiles between diabetic and nondiabetic patients with coronary artery disease in a Chinese population.
- Source :
-
Diabetes research and clinical practice [Diabetes Res Clin Pract] 2009 Aug; Vol. 85 (2), pp. 213-9. Date of Electronic Publication: 2009 Jun 06. - Publication Year :
- 2009
-
Abstract
- Background: It is well known that diabetes mellitus (DM) is a crucial risk factor for coronary artery disease (CAD). The present study aimed to investigate angiographic profiles of the coronary arteries in diabetic CAD patients in comparison with nondiabetics.<br />Methods: A total of 546 Chinese patients were angiographically documented for CAD, 375 of whom were diabetics and 171 were nondiabetics according to the WHO diabetes criteria (1999). The patients in these two groups were matched for age, sex, and body mass index (BMI). The 75 g oral glucose tolerance test (OGTT) was performed in all patients, for whom blood glucose, insulin, glycosylated hemoglobin (HbA1c), triglyceride (TG), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), apolipoprotein A (ApoA), apolipoprotein B (ApoB), and lipoprotein(a) [Lp(a)] were measured. Insulin resistance (Homa-IR) and insulin secretion index (Homa-IS) were determined by the HOMA model. The clinical features and the data from selective coronary angiographies were compared between the diabetic and nondiabetic CAD patients.<br />Results: Diabetic CAD patients had significantly higher waist to hip ratio (WHR) (p=0.016), fasting plasma glucose (FPG), 2h plasma glucose (2hPG), glycosylated hemoglobin (HbA1c) (p<0.001), insulin resistance index (Homa-IR) (p=0.001), and apolipoprotein A (ApoA) (p=0.008), with a significantly lower insulin secretion index (Homa-IS) level (p<0.001). Diabetic patients had one-vessel disease less frequently (28.8% vs 46.2%, p<0.001), and three-vessel disease more frequently (35.2% vs 24.0%, p=0.009), and they also had significantly higher cumulative coronary atherosclerosis score (CAS) (p=0.003). The right coronary artery was significantly more frequently involved in diabetics (66.4% vs 52.6%, p=0.002), with a clearly higher CAS at the same time (p=0.002).<br />Conclusions: Diabetics were presented with more severe and diffuse angiographically documented coronary artery disease compared to nondiabetics. The right coronary artery was significantly more frequently involved in the diabetics. Duration of CAD, Homa-IR, and diabetes mellitus were the independent risk factors for CAD found in the present study, while ApoA was the protective one.
- Subjects :
- Aged
Blood Glucose metabolism
China
Diabetic Angiopathies blood
Female
Glucose Tolerance Test
Glycated Hemoglobin metabolism
Humans
Insulin blood
Insulin metabolism
Insulin Resistance
Insulin Secretion
Male
Middle Aged
Waist-Hip Ratio
Coronary Angiography methods
Coronary Disease diagnostic imaging
Diabetic Angiopathies diagnostic imaging
Subjects
Details
- Language :
- English
- ISSN :
- 1872-8227
- Volume :
- 85
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Diabetes research and clinical practice
- Publication Type :
- Academic Journal
- Accession number :
- 19501926
- Full Text :
- https://doi.org/10.1016/j.diabres.2009.05.010