BACKGROUND Coronary heart disease(CHD)is a prevalent type 2 diabetes mellitus(T2DM)complication.Further,the risk stratification before angiography may help diagnose T2DM with CHD early.However,few studies have investi...BACKGROUND Coronary heart disease(CHD)is a prevalent type 2 diabetes mellitus(T2DM)complication.Further,the risk stratification before angiography may help diagnose T2DM with CHD early.However,few studies have investigated the coronary imaging characteristics and risk factors of patients with T2DM complicated with CHD.AIM To compare the differences in coronary imaging between patients with T2DM with and without CHD,determine the risk factors of T2DM complicated with CHD,and establish a predictive tool for diagnosing CHD in T2DM.METHODS This study retrospectively analyzed 103 patients with T2DM from January 2022 to May 2024.They are categorized based on CHD occurrence into:(1)The control group,consisting of patients with T2DM without CHD;and(2)The observation group,which includes patients with T2MD with CHD.Age,sex,smoking and drinking history,CHD family history,metformin(MET)treatment pre-admission,body mass index,fasting blood glucose(FBG),triglyceride(TG),total cholesterol,high-density lipoprotein cholesterol,low-density lipoprotein cholesterol(LDL-C),serum creatinine,blood urea nitrogen(BUN),alanine aminotransferase,aspartate aminotransferase,glycosylated hemoglobin(HbA1c),and coronary imaging data of both groups were collected from the medical record system.Logistic risk analysis was conducted to screen risk factors.The prediction model’s prediction efficiency was evaluated with receiver operating characteristic curves.RESULTS The control and observation groups consisted of 48 and 55 cases,respectively.The two groups were statistically different in terms of age(t=2.006,P=0.048),FBG(t=6.038,P=0.000),TG(t=2.015,P=0.047),LDL-C(t=2.017,P=0.046),and BUN(t=2.035,P=0.044).The observation group demonstrated lower proportions of patients receiving MET(χ^(2)=5.073,P=0.024)and higher proportions of patients with HbA1c of>7.0%(χ^(2)=6.980,P=0.008)than the control group.The observation group consisted of 15,17,and 23 cases of moderate stenosis,severe stenosis,and occlusion,respectively,with a greater number of coronary artery occlusion cases than the control group(χ^(2)=6.399,P=0.041).The observation group consisted significantly higher number of diffuse lesion cases at 35 compared with the control group(χ^(2)=15.420,P=0.000).The observation group demonstrated a higher right coronary artery(RCA)stenosis index(t=6.730,P=0.000),circumflex coronary artery(LCX)stenosis index(t=5.738,P=0.000),and total stenosis index(t=7.049,P=0.000)than the control group.FBG[odds ratio(OR)=1.472;95%confidence interval(CI):1.234-1.755;P=0.000]and HbA1c(OR=3.197;95%CI:1.149-8.896;P=0.026)were independent risk factors for T2DM complicated with CHD,whereas MET(OR=0.350;95%CI:0.129-0.952;P=0.040)was considered a protective factor for CHD in T2DM.CONCLUSION Coronary artery occlusion is a prevalent complication in patients with T2DM.Patients with T2MD with CHD demonstrated a higher degree of RCA and LCX stenosis than those with T2DM without CHD.FBG,HbA1c,and MET treatment history are risk factors for T2DM complicated with CHD.展开更多
BACKGROUND Cardiovascular disease is a major complication of diabetes mellitus(DM).Type-2 DM(T2DM)is associated with an increased risk of cardiovascular events and mortality,while serum biomarkers may facilitate the p...BACKGROUND Cardiovascular disease is a major complication of diabetes mellitus(DM).Type-2 DM(T2DM)is associated with an increased risk of cardiovascular events and mortality,while serum biomarkers may facilitate the prediction of these outcomes.Early differential diagnosis of T2DM complicated with acute coronary syndrome(ACS)plays an important role in controlling disease progression and improving safety.AIM To investigate the correlation of serum bilirubin andγ-glutamyltranspeptidase(γ-GGT)with major adverse cardiovascular events(MACEs)in T2DM patients with ACS.METHODS The clinical data of inpatients from January 2022 to December 2022 were analyzed retrospectively.According to different conditions,they were divided into the T2DM complicated with ACS group(T2DM+ACS,n=96),simple T2DM group(T2DM,n=85),and simple ACS group(ACS,n=90).The clinical data and laboratory indices were compared among the three groups,and the correlations of serum total bilirubin(TBIL)levels and serumγ-GGT levels with other indices were discussed.T2DM+ACS patients received a 90-day follow-up after discharge and were divided into event(n=15)and nonevent(n=81)groups according to the occurrence of MACEs;Univariate and multivariate analyses were further used to screen the independent influencing factors of MACEs in patients.RESULTS The T2DM+ACS group showed higherγ-GGT,total cholesterol,low-density lipoprotein cholesterol(LDL-C)and glycosylated hemoglobin(HbA1c)and lower TBIL and high-density lipoprotein cholesterol levels than the T2DM and ACS groups(P<0.05).Based on univariate analysis,the event and nonevent groups were significantly different in age(t=3.3612,P=0.0011),TBIL level(t=3.0742,P=0.0028),γ-GGT level(t=2.6887,P=0.0085),LDL-C level(t=2.0816,P=0.0401),HbA1c level(t=2.7862,P=0.0065)and left ventricular ejection fraction(LEVF)levels(t=3.2047,P=0.0018).Multivariate logistic regression analysis further identified that TBIL level and LEVF level were protective factor for MACEs,and age andγ-GGT level were risk factors(P<0.05).CONCLUSION Serum TBIL levels are decreased andγ-GGT levels are increased in T2DM+ACS patients,and the two indices are significantly negatively correlated.TBIL andγ-GGT are independent influencing factors for MACEs in such patients.展开更多
基金Supported by the Science and Technology Major Project of Changzhou Science and Technology Bureau,No.CE20205047Natural Science Foundation of Xinjiang Uygur Autonomous Region,No.2022D01F52Changzhou A Major Scientific Research Project of the Municipal Health Commission,No.ZD202220.
文摘BACKGROUND Coronary heart disease(CHD)is a prevalent type 2 diabetes mellitus(T2DM)complication.Further,the risk stratification before angiography may help diagnose T2DM with CHD early.However,few studies have investigated the coronary imaging characteristics and risk factors of patients with T2DM complicated with CHD.AIM To compare the differences in coronary imaging between patients with T2DM with and without CHD,determine the risk factors of T2DM complicated with CHD,and establish a predictive tool for diagnosing CHD in T2DM.METHODS This study retrospectively analyzed 103 patients with T2DM from January 2022 to May 2024.They are categorized based on CHD occurrence into:(1)The control group,consisting of patients with T2DM without CHD;and(2)The observation group,which includes patients with T2MD with CHD.Age,sex,smoking and drinking history,CHD family history,metformin(MET)treatment pre-admission,body mass index,fasting blood glucose(FBG),triglyceride(TG),total cholesterol,high-density lipoprotein cholesterol,low-density lipoprotein cholesterol(LDL-C),serum creatinine,blood urea nitrogen(BUN),alanine aminotransferase,aspartate aminotransferase,glycosylated hemoglobin(HbA1c),and coronary imaging data of both groups were collected from the medical record system.Logistic risk analysis was conducted to screen risk factors.The prediction model’s prediction efficiency was evaluated with receiver operating characteristic curves.RESULTS The control and observation groups consisted of 48 and 55 cases,respectively.The two groups were statistically different in terms of age(t=2.006,P=0.048),FBG(t=6.038,P=0.000),TG(t=2.015,P=0.047),LDL-C(t=2.017,P=0.046),and BUN(t=2.035,P=0.044).The observation group demonstrated lower proportions of patients receiving MET(χ^(2)=5.073,P=0.024)and higher proportions of patients with HbA1c of>7.0%(χ^(2)=6.980,P=0.008)than the control group.The observation group consisted of 15,17,and 23 cases of moderate stenosis,severe stenosis,and occlusion,respectively,with a greater number of coronary artery occlusion cases than the control group(χ^(2)=6.399,P=0.041).The observation group consisted significantly higher number of diffuse lesion cases at 35 compared with the control group(χ^(2)=15.420,P=0.000).The observation group demonstrated a higher right coronary artery(RCA)stenosis index(t=6.730,P=0.000),circumflex coronary artery(LCX)stenosis index(t=5.738,P=0.000),and total stenosis index(t=7.049,P=0.000)than the control group.FBG[odds ratio(OR)=1.472;95%confidence interval(CI):1.234-1.755;P=0.000]and HbA1c(OR=3.197;95%CI:1.149-8.896;P=0.026)were independent risk factors for T2DM complicated with CHD,whereas MET(OR=0.350;95%CI:0.129-0.952;P=0.040)was considered a protective factor for CHD in T2DM.CONCLUSION Coronary artery occlusion is a prevalent complication in patients with T2DM.Patients with T2MD with CHD demonstrated a higher degree of RCA and LCX stenosis than those with T2DM without CHD.FBG,HbA1c,and MET treatment history are risk factors for T2DM complicated with CHD.
基金Supported by Science and Technology Major Project of Changzhou Science and Technology Bureau,No.CE20205047Natural Science Foundation of Xinjiang Uygur Autonomo us Region,No.ZD202220Changzhou A major scientific research project of the Municipal Health Commission,No.2022D01F52.
文摘BACKGROUND Cardiovascular disease is a major complication of diabetes mellitus(DM).Type-2 DM(T2DM)is associated with an increased risk of cardiovascular events and mortality,while serum biomarkers may facilitate the prediction of these outcomes.Early differential diagnosis of T2DM complicated with acute coronary syndrome(ACS)plays an important role in controlling disease progression and improving safety.AIM To investigate the correlation of serum bilirubin andγ-glutamyltranspeptidase(γ-GGT)with major adverse cardiovascular events(MACEs)in T2DM patients with ACS.METHODS The clinical data of inpatients from January 2022 to December 2022 were analyzed retrospectively.According to different conditions,they were divided into the T2DM complicated with ACS group(T2DM+ACS,n=96),simple T2DM group(T2DM,n=85),and simple ACS group(ACS,n=90).The clinical data and laboratory indices were compared among the three groups,and the correlations of serum total bilirubin(TBIL)levels and serumγ-GGT levels with other indices were discussed.T2DM+ACS patients received a 90-day follow-up after discharge and were divided into event(n=15)and nonevent(n=81)groups according to the occurrence of MACEs;Univariate and multivariate analyses were further used to screen the independent influencing factors of MACEs in patients.RESULTS The T2DM+ACS group showed higherγ-GGT,total cholesterol,low-density lipoprotein cholesterol(LDL-C)and glycosylated hemoglobin(HbA1c)and lower TBIL and high-density lipoprotein cholesterol levels than the T2DM and ACS groups(P<0.05).Based on univariate analysis,the event and nonevent groups were significantly different in age(t=3.3612,P=0.0011),TBIL level(t=3.0742,P=0.0028),γ-GGT level(t=2.6887,P=0.0085),LDL-C level(t=2.0816,P=0.0401),HbA1c level(t=2.7862,P=0.0065)and left ventricular ejection fraction(LEVF)levels(t=3.2047,P=0.0018).Multivariate logistic regression analysis further identified that TBIL level and LEVF level were protective factor for MACEs,and age andγ-GGT level were risk factors(P<0.05).CONCLUSION Serum TBIL levels are decreased andγ-GGT levels are increased in T2DM+ACS patients,and the two indices are significantly negatively correlated.TBIL andγ-GGT are independent influencing factors for MACEs in such patients.
