To Explore The Significance Of Taking Oral Glucose Tolerance Test In Coronary Heart Disease Patients With Normal Fasting Glucose

Objective: Impaired glucose regulation,especially impaired glucose tolerance is the major risk factor for coronary heart disease,which increases the rate of cardiovascular morbidity and mortality.Impaired glucose tolerance is common phenomena existing in the cardiovascular patients with normal fasting glucose. The prevalence of abnormal glucose metabolism would be obviously underestimated by measuring FPG only.Oral glucose tolerance test(OGTT) is standard screening method for impaired glucose regulation(IGR) and diabetes mellitus(DM).This experiment was conducted to explore the significance of taking oral glucose tolerance test in coronary heart disease patients with normal fasting glucose.Statistical analysis was performed with SPSS17.0 software.Normality test.Method: A total of 100 cases with coronary heart disease(CHD) with undiagnosed diabetes patients were selected between December 2013 and December 2014,including 70 males and 30 females,with a mean age of 60 years. All selected subjects were diagnosed coronary heart disease. To take OGTT in 100 patient with normal fasting glucose, and analysis the following data.According to the diagnostic of 2012 :Impaired fasting glucose(IFG): 6.1mmol / L≤FPG<7.0 mmol / L,2h PG<7.8 mmol/L;Impaired glucose tolerance(IGT): FPG<7.0mmol/L and 7.8 mmol/L<2h PG<11.1 mmol/L;Impaired glucose regulation(IGR): 6.1mmol/L≤FPG<7.0 mmol/L and 7.8 mmol/L<2h PG<11.1mmol/L;Diabetes mellitus(DM): FPG≥7.0 mmol/L or 2h PG≥11.1mmol/L.The patients were divided into three groups, which were diabetes mellitus(DM), impaired glucose tolerance(IGT), and normal glucose regulation(NGT). Their demographic data including sex, age, waist circumfer- ence, hypertension history, smoking history, diabetic family history, body mass index(BMI),and so on. Their blood samples were drawn after a fasting period of 12 hours, and serum total cholesterol(TC),triglycerides(TG),low density lipoprotein cholesterol(LDL-C), and high density lipoprotein cholesterol(HDL-C) was collected. Normality test were performed on parametric variables, they were expressed as mean ±standard deviation(SD) if normal, then Homogeneity of variance test was done. If the variance was homogeneity, compared the two groups in the way of nonparametric test. The parametric variable were expressed as median when they were not normal, and comparison of group by nonparametric test. Categorical variables were expressed as percentages(%).The Logistic regression analysis screen the related risk factors A P value less than 0.05 was accepted as statistically significant difference.Results: In be selected CHDs,with normal fasting glucose,29%patients with impaired glucose tolerance and 13% patients with newly diagnosed diabetes could be diagnosed in time by OGTT. Compared the two groups patients who IGTs and NGTs, the results showed that smoking, sex, hyperten- sion history,BMI, high density lipoprotein cholesterol(HDL-C) had a statistically significant difference between the 2 groups(P<0.05). Compared the two groups patients who DMs and NGTs, the results showed that smoking, waist circumference and BMI had a statistically significant difference between the 2 groups(P<0.05). Compared the two groups patients who DMs and IGTs, the results showed that smoking and waist circumference had a statistically significant difference between the 2 groups(P<0.05).The males patients with the proportion of smoking, hypertension history, high density lipoprotein cholesterol(HDL-C) were higher than in female patients. The differences was statistically significant. The Logistic regression analysis screen the related risk factors. the results showed that both smoking and waist circumference are independent predictors for the presence of postchallenge hyperglycaemia.Blood sugar rise with the increase of the waist circumference.Conclusions: In patients who have coronary heart disease with normal Fasting plasma glucose,42% of them have undiagnosed Glucose homeostasis disorders。Simple Fasting blood glucose test may lead to missed diagnosis of Glucose homeostasis disorders. Patients who have coronary heart disease with normal Fasting plasma glucose,especially in those who have smoking history or/and waistline(male≥90cm,female≥80cm),may take OGTT promptly to check the existent Glucose homeostasis disorders.