Impaired Fasting Glucose And Coronary Heart Disease

Objective: In order to identify whether impaired fasting glucose is coronary heart disease's risking factor; After impaired fasting glucose's lower threshold value was changed to 5.6mmol/L by ADA, it's necessary to discuss the correlation between impaired fasting glucose and coronary heart disease.Methods: All the patients in our cardiovascular department of the first hospital of Jilin university were observed since 2006, Feb who underwent coronary angiography and other chemical examination including PFG,2hPG,BMI,blood-fat ( including: TG, TC, HDL-C, LDH-C, LP(α)),Hepatic function, renal function. Meanwhile, age, sex, hypertensive history, smoking history, diabetes mellitus history were recorded clearly. The professional physician scored their lesion of coronary arteries by Gensini scoring system, and record the multiplicity affection modality-long coronary lesions, three-vessel disease, bifurcation coronary artery lesion, left main coronary artery disease. To observe the relation between fasting glucose and other risking factor of coronary heart disease, all the subjects were grouped according to the different fasting glucose level. The relation between impaired fasting glucose and CHD was analyzed by the method of logistic multiple regression analysis.All the subjects were grouped according to different fasting glucose level, group1: FPG <5.6mmol/L, group2: 5.6≤FPG<6.1mmol/L, group3: 6.1≤FPG <7.0mmol/L, group4: FPG≥7.0mmol/L. Comparing every group's CHD risk factors and the lesion degree of coronary arteries. Statistics all the data by SPSS14.0 statistical package, numeration data demonstrated by percentage, deploying chi-squar check-up,Seting up P<0.05, the difference is distinguished and it has statistical significance. measurement data demonstrated by x±s, progressing t-test. First, carry out single factor analysis to all the important CHD risk factors, screening variances that has statistical significance. Then begaining Logistic multiple regression analysis, variances whose P<0.1 were brought into equations, calcuating OR value, and programing retrospective verification for CHD's possibility pattern.Result:①From group 1 to 4, patients'age,BMI,Gensini coronary score,hypertension morbidity step up gradually, which have statistics difference, whose P values in order: P=0.003, P<0.001,P<0.001,P=0.01; CHD morbidity,three-vessel disease,three-vessel disease incidence are obviously different, which have statistical significance, whose P values in order: P<0.001,P=0.017,P<0.001. That is to say: follow the ascend of fasting glucose, patients'age,BMI,coronary score,CHD,hypertension morbidity,long coronary lesions,three-vessel disease incidence gradually increase, differences among every group have statistical significance.②After progress single risk factor analysis to 9 species CHD risk factors, we discovered: DM history, smoking, hypertension, age, BMI, FPG are CHD's risk factors. Then carry out Logistic multiple regression analysis to these 6 species risking factors, among them there are five variates were brought into regression equation. The order that they affect CHD from great to little is smoking,hypertension,FPG,BMI,age, their OR values by turns are 2.490,1.564,1.441(95%CI 1.174～1.770,P=0.001),1.114,1.064.③Progress signal factor analysis to patients who has not DM history and whose FPG<7.0mmol/L ,suppose different divided point gradually. When take 6.1 as the divided point, finding: smoking,hypertension,age,BMI,6.1≤FPG <7.0mmol/L are CHD's risk factors. Then progress Logistic multiple regression analysis to these 5 species risk factors. Among them smoking, 6.1≤FPG<7.0mmol/L, age are brought into regression equation, whose OR values in turn are 2.714, 2.625(95%CI 1.314～5.243,P=0.006), 1.074。④Progress signal factor analysis to patients whose FPG<6.1mmol/L, suppose different divided point gradually. When take 5.6 as the divided point, finding: smoking,hypertension,age,BMI,5.6≤FPG <6.1mmol/L are CHD's risk factors. Then progress Logistic multiple regression analysis to these 5 species risk factors. Among them hypertension,age,smoking,5.6≤FPG <6.1mmol/L are brought into regression equation, whose OR values in turn are 4.418,2.780,1.772,1.066(95%CI 1.033~1.101,P<0.001)。Conclusion: Impaired fasting glucose (6.1mmol/L≤FPG<7.0mmol/L) is coronary heart disease's risk factor. Persons with FPG between 5.6 and 6.1mmol/L are apt suffer from CHD, compared to that of FPG <5.6 mmol/L group. New increase IFG (5.6mmol/L≤FPG <6.1mmol/L) is confirmed the dangerous interal for the generation of CHD. Consequently, to control fasting glucose under 5.6mmol/L is more safe. Accordingly, the lower threshold value of impaired fasting glucose was decreased to 5.6mmol/L by ADA in 2003, which is significant to prevent the generation or progression of CHD.