A Correlation Analysis Between Risk Factors Of Diabetes Mellitus And Gensini Score Of Coronary Artery Disease

Background:Type 2 diabetes mellitus has become a vital disease that threatens Chinese’s physical and mental health.Type 2 diabetes complicated with macroangiopathy,especially with coronary heart disease,has become the dominating cause of death in type 2 diabetes.But for the patients with type 2 diabetes complicated with coronary atherosclerotic heart disease(CAD),the clinical symptoms are always not obvious,and it is very tough for doctors the to treat.If the severity of coronary artery disease can be accurately assessed at the early stage of the type 2 diabetes complicated with coronary heart disease,the incidence of adverse cardiovascular events,such as acute myocardial infarction,will be reduced to a large extent.At the present time,there are a number of studies suggested that the risk factors such as free fatty acids and non-alcoholic fatty liver disease may be related to the coronary artery disease.The coronary Gensini score is a score based on the results of coronary angiography,which can be used to evaluate the severity of coronary lesions.This article mainly explores the correlation between serum free fatty acid,nonalcoholic fatty liver and the degree of coronary artery disease in patients with type 2 diabetes combined with coronary heart disease,and provides a clue to accurately assess the coronary lesions in patients with type 2 diabetes and coronary heart disease.Methods:171 patients diagnosed with CAD were admitted to our department of Cardiology.from 2016 to 2017.Those people were divided into 78 cases in DM+CAD group(type 2 diabetes combined with coronary heart disease)and 93 cases in CAD group(simple coronary heart disease group).Meanwhile,50 patients with type 2 diabetes mellitus(all excluded diabetic macroangiopathy)were randomly selected as the DM group in the endocrinology department.50 healthy persons in medical examination center were randomly selected as the NC group(normal control group).The the basic information,the laboratory results of the patients,the results of abdominal ultrasound and the results of coronary arteriography were collected,and the clinical retrospective analysis was carried out,and we use the SPSS 23 software for statistical treatment.Results:1.The difference between the DM group with the NC group in BMI(P<0.05),FPG(P<0.05),Hb Alc(P<0.05),FFA(P<0.05),and the prevalence of NAFLD(P<0.05)were significant,and BMI、FFA level and the prevalence of NAFLD in DM group was obviously higher than the NC group.2.There were significant differences in Gensini score(P=0.010)between the DM+CAD group and CAD group,and the Gensini score of coronary lesion in DM+CAD group was significantly higher than that in CAD group.The coronary artery lesions in DM+CAD group were mainly multivessel lesions,and the proportion of severe coronary lesions was higher than that in CAD group.3.The correlation analysis between the risk factors of diabetes and coronary Gensini score were analyzed by Pearson correlation.The results showed that there was a linear correlation between Hb Alc,FFA with coronary Gensini score.With Hb Alc,FFA,and NAFLD as independent variables,the Gensini score of coronary artery disease multiple regression analysis showed that the effects of Hb Alc and NAFLD on Gensini score were statistically significant(P < 0.05).There was significant difference in serum FFA level between patients with different coronary artery lesions.The serum FFA level was the highest in the three vessel disease group,followed by the two vessel disease group,and finally the single vessel lesion group.Conclusion:The Gensini score of DM+CAD group is significantly higher than that of CAD group,and diabetes may further aggravate the degree of coronary artery disease.For patients with type 2 diabetes mellitus with coronary heart disease,the level of serum FFA was positively correlated with the Gensini score of coronary lesion,and the more the severity of coronary artery disease,the more the number of lesions,the higher the level of serum FFA.NAFLD is positively correlated with Gensini score of coronary artery disease.The presence of NAFLD maybe aggravate the severity of coronary artery disease.The study has some limitations,and the conclusion remains to be further confirmed by a larger,long-term follow-up prospective clinical study.