| Objective To study the changes and clinical significance of of erum albumin(glycated albumin, GA), glycosylated hemoglobin(glycosylated hemoglobin A1 c, Hb A1c), blood glucose, blood lipid, brain natriuretic peptide(BNP) and biochemical indexes in patients with coronary heart disease and Type 2 Diabetes Mellitus, At the same time,to research the application value of Hb A1 c and GA in patients with coronary heart disease and Type 2 Diabetes Mellitus.Methods 1.The total of 103 cases of coronary heart disease and Type 2 Diabetes Mellitus from geriatric Cardiology and endocrinology department of the First Affiliated Hospital of Anhui Medical University were collected during January 2014 to June 2015. They were divided into 3 groups: Stable angina group(SAP group), unstable angina diabetic pectoris(UAP group), Diabetes complicating acute myocardial infarction group(AMI group). And the control group was formed by 34 Type 2 Diabetes Mellitus. BNP、GA、Hb A1 C level and other serological indicators were tested, UCG were performed to learn the LVEF. Study the difference of BNP,GAand Hb A1 C level between groups, and their correlation with LVEF. 2. Analysis of diagnostic sensitivity and specificity of GA, Hb A1 c and other indicators in type 2 diabetic patients with coronary heart disease through determination of serum GA and Hb A1 c, and draw the receiver operating characteristic curve(ROC curve).3. Analysis of the correlation between GA and Hb A1 C and such index as with or without hypertension, whether smoking or not, FPG, 2h PG, CRP using single factor analysis, so to provide for clinical basis of prevention and monitoring patients with diabetes mellitus complicated with coronary heart disease.Results: 1.There was no significant difference in indexs of TC, LDL-C, FPG, smoking, 2h PG level between groups(P>0.05).However, there were significant differences in systolic blood pressure and HDL-C(P < 0.05). GA, BNP value is higher in diabetes mellitus complicated with SAP group, UAP group, AMI group than the diabetes group(20.58±4.25, 20.12±4.40, 21.10±4.16 and 16.96±1.60, P < 0.001);(49.12±20.12,263.52±82.65, 724.23±224.65 and 45.48±17.23). LVEF in three subgroups of coronary heart disease patients were significantly lower than that of DM group. Comparison of concentration of serum Hb A1 c between the four groups have no significant difference(7.69±1.62 and 7.51±1.36, 7.74±1.34 and 7.51±1.38, P>0.05). 2.Receiver operating characteristic curve was drew in diabetic patients with coronary heart disease(CHD) group. The results showed that area under the ROC curve of GA was larger thanthat of Hb A1c(0.701 and 0.568, P = 0.046); Diagnosis critical point value was17.6% for GA and 6.9% for Hb A1 C, and sensitivity of GA was high than that of Hb A1c(74.1% and 54.9%). 3. Single factor correlation analysis indicated that Hb A1 c and FPG were positively related in diabetic patients with coronary heart disease group and DM group. r = 0.432, 0.729(P < 0.001). Hb A1 c and 2h PG was positively correlated. r= 0.321, 0.753(P = 0.001). Besides, GA and FPG were positively related in diabetes mellitus with coronary heart disease group and DM group. r=0.466 and 0.731,respectively. GA and 2h PG was also positively correlated with r value 0.382 and 0.751, respectively.Conclusion:1.GA is a sensitive marker of diabetes mellitus complicated with coronary heart disease, and it may be better than Hb A1 c in screening for patients with type 2 diabetes mellitus with coronary heart disease; 2.For patients with coronary heart disease and diabetes, the correlation between GA and instantaneous blood glucose(FPG, 2h PG) increases. 3.Combined detection of GA and BNP is more sensitive in evaluate the prognosis of high-risk diabetic patients with coronary heart disease. |
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