| Objective: To explore the relationship between glycosylated hemoglobin glycation index(HGI)and the degree of coronary artery stenosis in patients with coronary heart disease and type 2 diabetes mellitus.Methods: From June,2020 to December,2021,patients with coronary artery disease complicated with type 2 diabetes were selected.According to the inclusion and exclusion criteria,408 patients were finally selected into this study.Gensini score was used to evaluate the degree of coronary artery stenosis.The fasting venous blood glucose(FPG)and measured glycated hemoglobin(Hb A1c)were analyzed by linear regression to obtain the linear regression equation for predicting Hb A1c(predicted Hb A1c=4.86+0.293*FPG)and calculate HGI(HGI= measured Hb A1 cpredicted Hb A1c).According to the HGI value(%),408 subjects were divided into three groups by quantile method,namely,low HGI group(LHGI ≤ 0.58),middle HGI group(≤ 0.58 < M-HGI < 0.38)and high HGI group(H-HGI≥0.38).The baseline information and coronary artery lesions among the three groups were compared.Then according to Gensini score,all patients were divided into low-middle risk group and high-risk group(lowmiddle risk group =0,high-risk group =1).Multivariate binary Logistic regression analysis was used to explore whether HGI was the independent influencing factor of coronary artery stenosis in patients with coronary heart disease and type 2 diabetes mellitus,and the independent influence of different HGI groups on coronary artery stenosis.ROC curve was drawn to evaluate the predictive value of HGI for the high risk of coronary artery stenosis in patients with coronary heart disease and type 2 diabetes mellitus.All the data in this study were statistically analyzed by SPSS26.0 statistical software,and indicates that the difference is statistically significant(P<0.05).Results: 1.There was no significant difference in gender,age,body mass index,incidence of hypertension,family history of early coronary heart disease,systolic blood pressure,diastolic blood pressure,left ventricular ejection fraction,left ventricular end diastolic diameter,white blood cells,hemoglobin,total cholesterol,triglyceride,high density lipoprotein,albumin,creatinine,uric acid and glutamyltransferase among the three groups(P > 0.05).The number of people with smoking history increased from low HGI group to high HGI group in turn,and there were significant differences between H-HGI group and L-HGI and M-HGI groups(P<0.05).There were statistically significant differences among FPG,Hb A1 c and LDL groups(P<0.05).Further analysis showed that there were statistically significant differences between LDL in H-HGI group and L-HGI group(P<0.05).In terms of the degree of coronary artery stenosis and lesion site,the Gensini scores of the three groups of subjects increased in turn [LHGI(29.52±22.27),M-HGI(38.97±22.74)and H-HGI(54.53±27.30)],and the differences among the three groups were statistically significant(P <0.05).The number and location of coronary artery lesions from L-HGI group to H-HGI group showed that single vessel lesions accounted for 50.0%,35.0% and 28.1% of group respectively.Two lesions accounted for 30.9%,42.3% and 40.7% of the group respectively.Three branches lesions accounted for 19.1%,22.6% and 31.1% of the group respectively.The difference was statistically significant(P<0.05).Lesions of left anterior descending coronary artery(LAD)accounted for 64.7%,73.7% and 83.0%of all groups respectively.Lesions of left circumflex coronary artery(LCX)accounted for 49.3%,46.0% and 58.5% in each group respectively.The lesions of right coronary artery(RCA)accounted for 54.4%,68.6% and62.2% of each group respectively.The lesion rate of LAD increased with the increase of HGI group(P<0.05),but there was no significant difference between LCX and RCA groups(P>0.05).2.Multivariate Logistic regression analysis showed that age,systolic blood pressure,low density lipoprotein,uric acid and HGI were independent influencing factors of coronary artery stenosis in patients with coronary heart disease and type 2 diabetes mellitus,among which HGI had a great influence on coronary artery stenosis [OR = 1.933,95% CI(1.393,2.682),P<0.001].After adjusting for confounding factors such as age,systolic blood pressure,low density lipoprotein,uric acid,etc.,the results of multivariate Logistic regression analysis showed that compared with L-HGI group,the risk of coronary artery stenosis in H-HGI group was about 7.899 times higher than that in L-HGI group [OR = 7.899,95% CI(2.495,25.011),P<0.001].3.ROC curve shows that the area under the curve for HGI to predict the high risk of coronary artery stenosis in CHD patients with T2 DM is 0.739,the best cutoff value is-0.098,the specificity is 56.2%,and the sensitivity is86.0%.Conclusion: 1.Compared with the low-middle HGI group,patients in the high HGI group had a higher rate of coronary artery lesions in three branches,and all three groups showed a higher rate of left anterior descending branch lesions.2.HGI is an independent factor influencing the degree of coronary artery stenosis in patients with coronary heart disease and type 2 diabetes mellitus.3.HGI has certain predictive value for coronary artery stenosis in patients with coronary heart disease and type 2 diabetes mellitus. |
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