Zand Parsa Amir Farhang, Ghadirian Laleh, Rajabzadeh Kanafi Sahar, Moradi Farsani Ehsan
Department of Cardiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Acta Med Iran. 2013 May 7;51(4):231-5.
Diabetes mellitus (DM) is the most prevalent metabolic disease worldwide and is associated with coronary artery disease (CAD). Therefore it is very important to find a clue to diagnose the presence of CAD as early as possible in DM patients. The aim of this study was to find any correlation between microalbuminuria (MAU) and the severity of CAD in patients with DM type 2. This was a cross sectional study that included 77 DM type 2 patients with suspected CAD that all of whom were performed coronary angiography in our hospital (from 2010 to 2011). Patients were divided into two groups, the case group (group 1) that includes patients with MAU and the control group (group 2) that include patients without MAU. Severity of CAD was estimated by using Gensini score and MAU was defined as the ratio of urine albumin to urine creatinine. Of 77 patients forty three (55.8%) were female, mean ± SD of their ages was 55.8 ± 10.3 and sixteen (21%) of them had MAU. Gensini score of case group was significantly higher than control group (94.94 ± 12 versus 33.25 ± 25.4, P<0.001). The linear regression analysis revealed urinary albumin to creatinine ratio (UA/CR) as an independent predictor for the severity of CAD (P<0.001). Based on the ROC curve, 10.25 was the best albumin level cut off point for differentiating Gensini score over and below 70. Area under curve was 0.9; sensitivity and specificity were 72% and 80%, respectively (P<0.001). According to this study, in patients with DM type2, MAU is an independent predictor of severity of coronary artery stenosis and reveals a positive correlation between MAU and the Gensini score.
糖尿病（DM）是全球最常见的代谢性疾病，与冠状动脉疾病（CAD）相关。因此，尽早找到诊断DM患者是否存在CAD的线索非常重要。本研究的目的是寻找2型糖尿病患者微量白蛋白尿（MAU）与CAD严重程度之间的相关性。这是一项横断面研究，纳入了77例疑似CAD的2型糖尿病患者，所有患者均于2010年至2011年在我院接受了冠状动脉造影。患者分为两组，病例组（第1组）包括有MAU的患者，对照组（第2组）包括无MAU的患者。CAD的严重程度采用Gensini评分评估，MAU定义为尿白蛋白与尿肌酐的比值。77例患者中，43例（55.8%）为女性，平均年龄±标准差为55.8±10.3岁，其中16例（21%）有MAU。病例组的Gensini评分显著高于对照组（94.94±12对33.25±25.4，P<0.001）。线性回归分析显示，尿白蛋白与肌酐比值（UA/CR）是CAD严重程度的独立预测因子（P<0.001）。根据ROC曲线，10.25是区分Gensini评分高于和低于70的最佳白蛋白水平切点。曲线下面积为0.9；敏感性和特异性分别为72%和80%（P<0.001）。根据本研究，在2型糖尿病患者中，MAU是冠状动脉狭窄严重程度的独立预测因子，且MAU与Gensini评分呈正相关。
