Department of Medicine, College of Medicine, China Medical University Hospital, Taichung, Taiwan.
Diabet Med. 2011 Apr;28(4):493-9. doi: 10.1111/j.1464-5491.2010.03213.x.
The presence of subclinical stenosed coronary segments and plaque subtypes has not been compared among those with metabolic syndrome, diabetes, or neither condition in middle-aged individuals. In select, intermediate-risk subjects, it may be reasonable to directly measure atherosclerosis burden by low-dose, multidetector-row computed tomographic coronary angiography.
We performed a cross-sectional analysis of 1024 consecutive, newly self-referred subjects (692 men, 332 women; mean age 53.0±9.7 years) who underwent health evaluation at the China Medical University Hospital. Participants had at least one cardiac risk factor, but no known coronary heart disease.
Among our 1024 subjects, 135 had diabetes, 334 had metabolic syndrome and 555 had neither condition. The subjects with diabetes and those with metabolic syndrome had a higher prevalence of non-calcified, calcified and mixed-type plaques and stenosed coronary segments than the subjects with neither condition (P<0.05). The odds ratios for diabetes and the presence of any plaque, mixed plaque, calcified plaque and stenosed segment compared with neither metabolic syndrome nor diabetes were 2.893, 3.629, 2.099 and 2.036, respectively, all of which were significant (P<0.05). The odds ratio for metabolic syndrome and the presence of any plaque compared with neither metabolic syndrome nor diabetes was 1.606 (95% CI 1.063-2.426; P<0.05).
In middle-aged subjects, diabetes was related to an increased risk of the presence of mixed plaques, calcified plaques and stenosed coronary segments. However, metabolic syndrome was related to an increased risk of the presence of any coronary plaque, but not related to stenosed coronary segments.
在中年人群中,尚未比较过代谢综合征、糖尿病和既无代谢综合征又无糖尿病的患者中存在亚临床狭窄的冠状动脉节段和斑块亚型。在选择的中危人群中,通过低剂量多层螺旋 CT 冠状动脉造影直接测量动脉粥样硬化负荷可能是合理的。
我们对在台湾中国医药大学附设医院进行健康评估的 1024 例连续新就诊的患者(男性 692 例,女性 332 例;平均年龄 53.0±9.7 岁)进行了一项横断面分析。参与者至少有一种心脏危险因素,但无已知的冠心病。
在我们的 1024 例患者中,135 例患有糖尿病,334 例患有代谢综合征,555 例既无糖尿病也无代谢综合征。与既无代谢综合征也无糖尿病的患者相比,患有糖尿病和代谢综合征的患者中非钙化、钙化和混合斑块以及狭窄的冠状动脉节段的发生率更高(P<0.05)。与既无代谢综合征也无糖尿病相比,糖尿病的存在与任何斑块、混合斑块、钙化斑块和狭窄节段的比值比分别为 2.893、3.629、2.099 和 2.036,均具有统计学意义(P<0.05)。代谢综合征的存在与任何斑块的比值比与既无代谢综合征也无糖尿病相比为 1.606(95%可信区间 1.063-2.426;P<0.05)。
在中年人群中,糖尿病与混合斑块、钙化斑块和狭窄的冠状动脉节段的存在风险增加相关。然而,代谢综合征与任何冠状动脉斑块的存在风险增加相关,但与狭窄的冠状动脉节段无关。