Hu Da-Yi, Pan Chang-Yu, Yu Jin-Ming
Centre for Cardiovascular and Pulmonary Blood Vessels, Tongji University, Shanghai, China.
Eur Heart J. 2006 Nov;27(21):2573-9. doi: 10.1093/eurheartj/ehl207. Epub 2006 Sep 19.
The aim of this article is to characterize the glucometabolic state of patients with coronary artery disease (CAD) in China.
This multicentre study recruited 3513 patients hospitalized for CAD, of whom 35.1% were admissions for acute CAD and 64.9% were elective admissions for CAD. At entry, 1153 patients had known type 2 diabetes and 97 had newly diagnosed diabetes [fasting plasma glucose level (FPG) > or =7.0 mmol/L]. Oral glucose tolerance tests (OGTTs) performed in the remaining patients revealed that 26.9% had diabetes and 37.3% had impaired glucose regulation (IGR). The prevalence of abnormal glucose regulation (AGR) was similar in the acute and elective admissions groups. Overall, the proportion of patients with diagnosed diabetes increased from 32.8% at baseline to 52.9% post-OGTT analysis. In total, 87.4% of patients with IGR and 80.5% of patients with diabetes would have remained undiagnosed if OGTTs had not been performed.
AGR is common in patients with CAD. The prevalence of AGR is underestimated by FPG testing alone. OGTTs should be routinely used to assess the glucometabolic state of patients with CAD. Individuals identified with IGR or type 2 diabetes should receive treatment to reduce the progression of AGR and associated complications.
本文旨在描述中国冠心病(CAD)患者的糖代谢状态。
这项多中心研究招募了3513名因CAD住院的患者,其中35.1%为急性CAD入院患者,64.9%为CAD择期入院患者。入院时,1153名患者已知患有2型糖尿病,97名患者为新诊断糖尿病[空腹血糖水平(FPG)≥7.0 mmol/L]。对其余患者进行的口服葡萄糖耐量试验(OGTT)显示,26.9%患有糖尿病,37.3%患有糖调节受损(IGR)。急性和择期入院组的糖调节异常(AGR)患病率相似。总体而言,诊断为糖尿病的患者比例从基线时的32.8%增至OGTT分析后的52.9%。如果未进行OGTT,总共87.4%的IGR患者和80.5%的糖尿病患者将仍未被诊断出来。
AGR在CAD患者中很常见。仅通过FPG检测会低估AGR的患病率。应常规使用OGTT来评估CAD患者的糖代谢状态。被诊断为IGR或2型糖尿病的个体应接受治疗,以减少AGR进展及相关并发症。