The Relationship Of Fasting Plasma Glucose And Coronary Heart Disease In Population Of Rural Areas In North Henan

BackgroundCoronary heart disease(CHD)is a serious threat to human health due to its high morbidity and disability rate,and Type 2 Diabetes Mellitus(T2DM)is closely related to CHD.Some patients with unestablished T2 DM and severe CHD are actually in pre-diabetes and often have Impaired Fasting Glucose(IFG).However,the IFG blood glucose values defined by WHO and ADA are not uniform.The relationship between fasting plasma glucose(FPG)levels and the incidence and severity of CHD in northern Henan is unclear.ObjectiveTo determine the relationship between FPG and the incidence and severity of CHD in rural areas of northern Henan,China.MethodA total of 2,987 patients from rural areas in northern Henan who underwent coronary angiography from January 2016 to June 2018 were selected from the Henan Engineering Research Center for Clinical Data and Biobank of Cardiovascular Diseases.Multivariate binary logistic regression was used to analyze risk factors for coronary heart disease in this region.Univariate analysis of the relationship between different levels of FPG and CHD in non-diabetic patients was assessed by Propensity Score Match(PSM)after adjusting for age,gender,smoking,drinking,hypertension,dyslipidemia,previous ischemic stroke history,and chronic kidney disease.The severity of coronary atherosclerosis was assessed by Gensini scores,and an orderly logistic regression was used to analyze the association between elevated FPG and the severity of coronary lesions.Result1.A total of 2987 patients were included in this study,53.8% of males(n=1607),CHD 66.9%(n=1997),T2 DM 22.3%(n=665),ADA-defined IFG 20%(5.6mmol/L;n=598),WHO defined IFG 8.7%(6.1mmol/L;n=260).2.Binary Logistic regression analysis showed that diabetes was an independent risk factor for CHD in men in this region(OR=2.774,95% CI 1.913-4.020,P<0.001).It is also a risk factor for women with coronary heart disease in this area.(OR=2.496,95% CI 1.868-3.335,P <0.001).3.After use the propensity scores to eliminate differences in confounding factors such as age,hypertension,dyslipidemia,smoking,drinking,chronic kidney disease,and previous ischemic stroke.Among women in this region,both WHO or ADA-defined IFG,the incidence of CHD was increased(WHO: OR=8.800,95% CI 4.863-15.92,P<0.001;ADA: OR= 5.932,95% CI 4.098-8.568,P<0.001),and the incidence of CHD began to increase when blood glucose exceeded 5.2 mmol/L(OR= 1.438,95% CI 1.099-1.880 P= 0.008).In men without diabetes,there was no significant correlation between the IFG defined by WHO or ADA and the incidence of CHD(WHO: OR= 0.873,95% CI 0.484-1.575,P= 0.652;ADA: OR= 0.779,95% CI 0.545-1.115,P= 0.172).4.Ordered Logistic regression analysis showed that the degree of CHD was more serious when women’s fasting blood glucose exceeded 5.2mmol/L(OR= 1.685,95%CI 1.302-2.184,P <0.001).5.The proportion of men wtih established CHD in this region who smoked(52.4% vs.40.0% P <0.001),had dyslipidemia(67.0% vs.1.1%,P<0.001),and consumed alcohol(33.5% vs.1.1% P <0.001).Women were higher: age of onset(62 vs.59 years old,P<0.001)and hypertension(78.6% vs.65.5%,P<0.001).Conclusion1.In non-diabetic women in rural areas of northern Henan,the incidence of CHD increased when the fasting blood glucose level was greater than 5.2 mmol/L.Increased fasting blood glucose in male patients was not significantly associated with CHD.2.Female patients with fasting blood glucose greater than 5.2 mmol / L have more severe coronary lesions.3.Increased fasting blood glucose in male patients was not significantly associated with CHD.Among the patients with coronary heart disease in this area,males have abnormal dyslipidemia and higher smoking rates than females.