Saltiki Katerina, Cimponeriu Adrianna, Lili Kyriaki, Peppa Melpomeni, Anastasiou Eleni, Alevizaki Maria
Endocrine Unit, Evgenidion Hospital and Department of Clinical Therapeutics, Alexandra University Hospital, Athens, Greece.
Hormones (Athens). 2008 Apr-Jun;7(2):148-55. doi: 10.1007/BF03401506.
Coronary artery disease (CAD) risk increases in women after the menopause. The aim of this study was to determine the effect of diabetes on the severity of CAD in postmenopausal women undergoing coronary angiography.
180 postmenopausal women underwent coronary angiography for suspected CAD. CAD severity was assessed by the number of arteries (0-3) with >50% stenosis in the angiography. Forty-four women had type 2 diabetes mellitus (T2DM). Predisposing risk factors and biochemical and hormonal parameters were recorded. The diabetic women were older (p=0.014), had higher BMI and waist circumference (p<0.001), higher prevalence of hypertension (p=0.002), higher levels of triglycerides, uric acid and higher HOMA-Insulin Resistance Index (p=0.009).
The women with diabetes had a higher prevalence of severe stenosis in the angiography: T2DM: 0-vessels 25%, 1-vessel disease 18.2%, 2-vessels disease 22.7%, 3-vessels disease 34.1%, vs. 49.2%, 23.5%, 22.1%, 5.1% in the non-diabetic women, respectively (p<0.001). Binary logistic regression analysis showed that T2DM was a significant predictor of severe CAD (>or=3 vessel disease) independently of age, family history of T2DM, BMI, time since menopause, hypertension and hypercholesterolemia. Women with T2DM also had lower sex hormone binding globulin (SHBG, p=0.010) levels compared to non-diabetic women.
Diabetic postmenopausal women develop more severe CAD compared to non-diabetic women. This association is independent of other predisposing factors and suggests an independent effect of T2DM on the atherosclerotic process, at least in women after menopause.
绝经后女性患冠状动脉疾病（CAD）的风险会增加。本研究的目的是确定糖尿病对接受冠状动脉造影的绝经后女性CAD严重程度的影响。
180名绝经后女性因疑似CAD接受冠状动脉造影。通过血管造影中狭窄>50%的动脉数量（0 - 3条）评估CAD严重程度。44名女性患有2型糖尿病（T2DM）。记录了易感风险因素以及生化和激素参数。糖尿病女性年龄更大（p = 0.014），体重指数（BMI）和腰围更高（p < 0.001），高血压患病率更高（p = 0.002），甘油三酯、尿酸水平更高且胰岛素抵抗指数（HOMA）更高（p = 0.009）。
糖尿病女性在血管造影中严重狭窄的患病率更高：T2DM组：0支血管病变占25%，1支血管病变占18.2%，2支血管病变占22.7%，3支血管病变占34.1%，而非糖尿病女性分别为49.2%、23.5%、22.1%、5.1%（p < 0.001）。二元逻辑回归分析表明，T2DM是严重CAD（≥3支血管病变）的重要预测因素，独立于年龄、T2DM家族史、BMI、绝经后时间、高血压和高胆固醇血症。与非糖尿病女性相比，T2DM女性的性激素结合球蛋白（SHBG，p = 0.010）水平也更低。
与非糖尿病绝经后女性相比，糖尿病绝经后女性患更严重的CAD。这种关联独立于其他易感因素，提示T2DM对动脉粥样硬化进程有独立影响，至少在绝经后女性中如此。
