Luo Guojing, Liu Hong, Luo Shunkui, Li Fang, Su Minhong, Lu Hongyun
Department of Endocrinology and Metabolism, the Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, Guangdong 519000, China.
Int J Endocrinol. 2014;2014:745093. doi: 10.1155/2014/745093. Epub 2014 Jul 14.
Previous studies had shown that elevated admission plasma glucose (APG) could increase mortality rate and serious complications of acute myocardial infarction (AMI), but whether fasting plasma glucose (FPG) had the same role remains controversial. In this retrospective study, 253 cases of AMI patients were divided into diabetic (n = 87) and nondiabetic group (n = 166). Our results showed that: compared with the nondiabetic patients, diabetic patients had higher APG, FPG, higher plasma triglyceride, higher rates of painless AMI (P < 0.01), non-ST-segment elevation myocardial infarction (NSTEMI), and reinfraction (P < 0.05). They also had lower high density lipoprotein cholesterol and rate of malignant arrhythmia, but in-hospital mortality rate did not differ significantly (P > 0.05). While nondiabetic patients were subgrouped in terms of APG and FPG (cut points were 11.1 mmol/L and 7.0 mmol/L, resp.), the mortality rate had significant difference (P < 0.01), whereas glucose level lost significance in diabetic group. Multivariate logistic regression analysis showed that FPG (OR: 2.014; 95% confidence interval: 1.296-3.131; p < 0.01) but not APG was independent predictor of in-hospital mortality for nondiabetic patients. These results indicate that FPG can be an independent predictor for mortality in nondiabetic female patients with AMI.
既往研究表明,入院时血浆葡萄糖(APG)升高可增加急性心肌梗死(AMI)的死亡率和严重并发症,但空腹血糖(FPG)是否具有同样作用仍存在争议。在这项回顾性研究中,253例AMI患者被分为糖尿病组(n = 87)和非糖尿病组(n = 166)。我们的结果显示:与非糖尿病患者相比,糖尿病患者的APG、FPG、血浆甘油三酯更高,无痛性AMI(P < 0.01)、非ST段抬高型心肌梗死(NSTEMI)及再梗死发生率更高(P < 0.05)。他们的高密度脂蛋白胆固醇及恶性心律失常发生率更低,但住院死亡率无显著差异(P > 0.05)。当非糖尿病患者按APG和FPG进行亚组分析时(切点分别为11.1 mmol/L和7.0 mmol/L),死亡率有显著差异(P < 0.01),而在糖尿病组中血糖水平无显著意义。多因素logistic回归分析显示,FPG(OR:2.014;95%置信区间:1.296 - 3.131;P < 0.01)而非APG是非糖尿病患者住院死亡率的独立预测因素。这些结果表明,FPG可作为非糖尿病女性AMI患者死亡率的独立预测因素。