| Background:Diabetes mellitus was positively related to atherosclerosis and considered as an equivalent of coronary artery disease by the National Cholesterol Education Program (NCEP) and Treatment of High Blood Cholesterol In Adults (Adult Treatment PanelⅢ) (NCEP-ATPⅢ) from 2001 on. Recent studies showed that postprandial hyperglycemia was also related to the cardioascular endpoint events. However, the relationship of postprandial hyperglycemia and atherosclerotic severity is not clarified yet.Objective:To investigate the correlations between different types of glucometabolic disorders and atherosclerotic severity and endothelial function.Materials and Methods1. Study population and groups.Totally 248 patients with coronary heart disease diagnosed by coronary angiography in our hospital from June 2008 to January 2010 were included. Those patients were divided into four groups according to the results of simplified oral glucose tolerance test (OGTT):no glucometablic disorder (group 1, n=52), impaired fasting glucose (group 2, n=32), impaired tolerence of glucose (group 3, n=84) and diabetes mellitus (group 4, n=80). The traditional cardiovascular risk factors such as blood pressure, smoking, hypercholesteromia and the general data of these patients were collected and recorded.2. Coronary angiography and the measurement of Gensini's score.Conventional left or right coronary angiography was performed via the femoral or radial approach. At least four projections for the left coronary artery and two perpendicular projections for the right coronary artery were taken during angiography. The Gensini's scores were measured on the quantified coronary angiography with Axion Artis dTA soft workstation (Siemens, Germany).3. Record and measurement of pulse wave velocity (PWV).PWV was recorded and measured in the other day of coronary angiography by SUN-8800 PWV detector (Shen Zhen SUNNICO Corporation). All of the records and measurements were taken by the same technician to reduce operational errors.4. Measurement of ET-1 and NO.ET-1 was measured by the homogeneous competitive radioimmunoassay method. NO was measured by nitrate reductase method. The standard procedure suggested by the producers were followed during the above measurements.Results1. There were no significant differences in age, sex, blood pressure, body mass index, smoking history, LDL-C, HDL-C, TG, TC between four groups (P> 0.05).2. The results of PWVThe trend of PWV in four groups was gradually rising from group 1 to group 4. PWV of Group 3 (389.60±49.32 cm/s) was closed to that of group 4 (398.80±54.73cm/s, P> 0.05) and much higher than that of group 1 (315.35±48.99cm/s, P<0.01) and group 2 (346.06±24.77cm/s, P<0.01). There was no significant differences between group 1 and group 2 (P>0.05).3. The results of ET-1.The results of ET-1 in four groups showed a tendency of gradually increasing from group 1 to group 4. ET-1 levels in group 3 (121.22±32.08 pg/ml) and group 4 (121.57±30.38 pg/ml) were significant higher than that in group 1 (102.28±36.49pg/ml) and group 2 (118.32±33.63, P< 0.01). There was no significant difference between group2 and group 1 (P>0.05) as well as between group 3 and group 4 (P>0.05). 4. The results of NO.The general trend of NO in four groups was gradually decreasing from group 1 to group 4. The NO level of group 4 (54.65±7.86μmol/L) was significant lower than that in group 3 (59.89±11.52μmol/L), group 2 (62.32±9.18μmol/L) and group 1 (65.32±10.49μmol/L, P<0.01). The NO level of group 3 was significant lower than that in group 1 (P<0.01). However, there were no significant differences between group 3 and group 2 (P>0.05) as well as between group 2 and group 1 (P>0.05).5. The results of Gensini's score.The trendency of Gensini scores'was echelon increasing from group 1 to group 4. The results of four group are 7.44±2.82 (group 1),12.23±6.10 (group 2), 28.30±4.53 (group 3),57.06±11.78 (group 4). There were statistically differences between any two groups (P<0.01). 6. Pearson bivariate correlation analysis showed that coronary atherosclerotic severity (The Gensini's score) was positive correlated to PWV (r=0.512, p=0.000),2hPG (r=0.759, p=0.000), UA (r=0.356, p=0.000), and TG (r=0.202, p=0.004)Conclusions1. Coronary atherosclerotic severity, peripheral vascular pulse wave velocity and endothelial function were different in patients with coronary artery disease and different types of glucometabolic disorders. The coronary atherosclerotic severity was more severe in the patients with postprandial hyperglycemia than in those with impaired fasting glucose and approached to in these with diabetes mellitus. Which indicated that more attentions should be paid to early intervention and treatment on patients with postprandial hyperglycemia.2. PWV of peripheral vessel was positive related to the coronary atherosclerotic severity, which hinted that PWV might indirectly reflect coronary atherosclerotic severity and also testified the systematic feature of atherosclerosis.
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