| Objective:The purpose of this study was to explore the correlation of serum uric acid to high-density lipoprotein cholesterol ratio(UHR)and heart rate variability(HRV)with coronary heart disease and the severity of coronary disease in patients with type 2 diabetes.Methods:Patients with T2 DM who were hospitalized in the Department of Cardiovascular Medicine and Hypertension at the First Hospital of Shanxi Medical University from June 1,2021 to October 31,2022 and who underwent coronary angiography according to the inclusion and exclusion criteria were selected for this study using a retrospective method.They were divided into T2 DM with CHD group and T2 DM group based on coronary angiography findings.In addition,100 non-T2 DM patients who met the inclusion and exclusion criteria and were not diagnosed with CHD by coronary angiography during the same period were selected as the control group.General clinical data such as age,sex,duration of T2 DM,smoking history,body mass index(BMI),systolic blood pressure(SBP),and diastolic blood pressure(DBP),first blood biochemical indicators after admission such as fasting blood glucose(FPG),uric acid(UA),urea(Urea),creatinine(Cr),total cholesterol(TC),triglyceride(TG),high-density lipoprotein cholesterol(HDL-C)and low-density lipoprotein cholesterol(LDL-C),HRV indicators such as standard derivation of all NN intervals(SDNN),standard derivation of the averages of NN intervals in all5-minute segments(SDANN),square root of the mean of the sum of the square of differences between adjacent NN intervals(r MSSD),percentage difference between adjacent NN intervals that are greater than 50ms(p NN50),triangular index(TRIIDX)and ratio of low-high frequency power(LF/HF),and the conclusions of coronary angiography were collected for all patients.Then we explored the correlation of serum uric acid to high-density lipoprotein cholesterol ratio(UHR)and heart rate variability(HRV)with coronary heart disease and the severity of coronary disease in patients with type 2 diabetes.Results:(1)There were no significant differences in BMI,DBP,TC,TG,and LDL-C among the three groups(P> 0.05).Gender(male proportion),proportion of smoking cases,T2 DM duration,SBP,FBG,and Urea in T2 DM group and T2 DM and CHD group were significantly higher than those in control group(P<0.05).Age,UA,and Cr in T2 DM and CHD group were significantly higher than those in T2 DM group and control group,and HDL-C level was significantly lower than that in control group(P<0.05).(2)Compared with T2 DM group and control group,UHR and Gensini score of T2 DM and CHD group were significantly higher,and SDNN,SDANN,r MSSD,p NN50,and TRIIDX were significantly lower(P<0.05).Compared with the control group,the r MSSD and p NN50 were significantly reduced in the T2 DM group(P<0.05).There was no significant difference in LF / HF between the three groups(P>0.05).(3)Univariate logistic regression analysis showed that age,T2 DM duration,UA,Cr,HDL-C,UHR,SDNN,SDANN,r MSSD,p NN50,and TRIIDX were the contributing factors of T2 DM with CHD(P<0.05).Further multivariate logistic regression analysis suggested that UHR(OR=1.08,95%CI: 1.04～1.11,P <0.001),age(OR=1.05,95%CI:1.01 ～ 1.10,P=0.018),reduced SDANN(OR=0.95,95%CI: 0.91 ～ 0.99,P=0.036),reduced p NN50(OR=0.86,95%CI: 0.74～0.99,P=0.037)were independent risk factors for T2 DM with CHD.(4)ROC curve analysis showed that the AUC of UHR,HRV and the combination of them predicting T2 DM with CHD were 0.69,0.68,and 0.76,respectively.The combined detection of UHR and HRV predicted T2 DM with CHD with a sensitivity of 0.69 and a specificity of 0.70.(5)All of T2 DM with CHD patients were classified into low,medium,high,and extremely high groups according to the Gensini score quartile method.The comparison of gender(male proportion),age,smoking case proportion,T2 DM duration,BMI,SBP,DBP,FBG,Cr,Urea,TC,TG,and HDL-C showed no difference between different groups(P>0.05).UA and UHR of the extremely high group were higher than the other three groups,and SDNN、p NN50、TRIIDX was lower(P<0.05).SDANN and r MSSD were lower in extremely high group compared to low and middle groups(P<0.05).Compared with low groups,SDNN,SDANN,TRIIDX,and LF/HF were lower in high group and extremely high group(P<0.05).(6)Spearman correlation analysis indicated that Gensini score showed a significant positive correlation with UA and UHR,and a significant negative correlation with HRV indicators(P <0.05).Multiple linear regression was introduced with Gensini score as dependent variable,T2 DM duration,FBG,UHR,and HRV as independent variables,and the results indicated that Gensini score showed a positive correlation with UHR,and a negative correlation with TRIIDX and r MSSD.Therefore,UHR,TRIIDX,and r MSSD were all correlated with the severity of coronary lesions in T2 DM with CHD patients.Conclusion:(1)Increased UHR,decreased SDANN,and decreased p NN50 were independent risk factors for T2 DM with CHD.The combined detection of UHR and HRV indicators can better predict the risk of combining CHD in patients with T2 DM.(2)A significant positive correlation was found between UHR and Gensini score,and a significant negative relationship was found between HRV indicators and Gensini score.UHR and HRV indicators can assess the severity of coronary lesions in patients with T2 DM and CHD. |
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