Prevalence Of Glucose Metabolism Disorders In Patients With Coronary Artery Disease And The Correlation Between Coronary Artery Lesions And Glucose Metabolism Status

Objective:To investigate the prevalence of glucose metabolism disorders in patients with Coronary Artery Disease(CAD) and the correlation between coronary artery lesions and glucose metabolism status,.Method:Coronary angiography was performed for 202 patients during January to September 2008,all patients were devided into four groups according to the results of coronary angiography:50 patients without coronary artery lesion as the control group,51patients with one-vessel lesion as the first group,51 patients with two-vessel lesion as the second group,and 50 patients with three-vessel lesion as the third group.Fasting plasma glucose(FPG),2-hour plasma glucose(2hPG,75g glucose load),plasma HbAlc levels land Total Cholesterol(TC),Triglyceride(TG), HDL-Cholesterol(HDL-C),LDL-Cholesterol(LDL-C),Systolic Blood Pressure(SBP), Dilated Blood Pressure(DBP),Body Mass Index(BMI) were measured,histories of smoking and mycardial infarction were recorded for all 202 patients. Results:1,Age,BMI,TG,TC,HDL-C,LDL-C,HDL-C,SBP,DBP,histories of smoking had no significant defferences among four groups respectively(P＞0.05).2,There were no significant differences in fasting plasma glucose among four groups(P＞0.05).Among the four groups,the 2-hour Plasma Glucose were 6.11±0.66mmol/l,7.62±4.21 mmol/l,10.75±3.53 mmol/l,11.64±3.19 mmol/l respectively and the plasma HbAlc levels were 5.55±0.70%,6.00±0.54%, 6.89±0.95%,7.32±1.41%respectively.For the 2hPG and plasma HbAlc levels,there were significant differences between the second and the control group,the first group respectively,the third and the control group,the the first group respectively(P＜0.05 ).3,The proportion of mycardial infarction were 0%,27.5%,30%,36%, respectively.4,The prevalence of glucose metabolism disorders was 44.7%in patients with CAD.Without the use of 2hPG,96.9%Impaired Glucose Tolarance(IGT) and 72.2%Diabetes Mellitus(DM) were missed diagnosis by fasting plasma glucose measurement alone.5,The prevalence of glucose metabolism disorders was significantly defferent among four groups respectively(8%vs17.6%vs45.1%vs72%,P＜0.05 ).6,According to the glucose metabolism status,,All patients were devided into Normal Glucose Tolerance(NGT),Impaired Glucose Regulation(IGR),DM with HbAlc＜8.0%and DM with HbAlc≥8.0%.The prevalence of multi-vessel coronary lesions was 32.3%,79.4%,78.6%,100%respectively, diffusing lesions was 18.5%,50%,53.6%,80%respectively.For the prevalence of multi-vessel lesions and diffusing lesions,there were no significant defferences between IGR group and DM with plasma HbAlc level＜8.0% group(P＞0.05 ),while either of the former two groups was compared with the NGT group or the DM with plasma HbAlc level≥8.0group,there were significant defferences respectively(P＜0.05 ).There were significant defferences between DM with HbAlc≥8.0%group with the others respectively(P＜0.05 ).7,There were significiant correlation between the number of coronary lesions and FPG,2hPG and HbAlc(r=0.398,0.685,0.740 respectively,P＜0.01 )Conclusion:The prevalence of glucose metabolism disorders is high in patients with CAD. glucose metabolism disorders were determined readily and timely by FPG and 2hPG for patients with CAD.There was the same severity of coronary lesions in IGR and DM patients.FPG,2hPG and plasma HbAlc levels were postively correlated with severity of coronary artery lesions.In order to prevent the development of CAD and the diabetic macroangiopathy,it is proposed to confirm and control the glucose metabolism disorderes timely by 2hPG routinely.