Jayashankar C A, Andrews Henley Punnen, Pinnelli Venkata BharatKumar, Shashidharan Basappaji, Nithin Kumar H N, Vemulapalli Swaapnika
Department of General Medicine, Vydehi Institute of Medical Sciences and Research Centre, Nallurhalli, Whitefield, Bangalore, Karnataka, India.
Department of General Medicine, St John's Hospital, Kattappana, Idukki, Kerala, India.
J Nat Sci Biol Med. 2016 Jul-Dec;7(2):161-5. doi: 10.4103/0976-9668.184703.
We aimed to identify the predictors of coronary artery disease (CAD) in patients with type 2 diabetes mellitus (type 2 DM).
About fifty Asian Indian patients with type 2 DM patients aged >40 years and fifty sex- and age-matched nondiabetic controls were enrolled for this study. Following complete medical history and baseline clinical data, laboratory investigations were performed to assess fasting and postprandial plasma glucose levels, lipid profile, blood urea, serum creatinine, and serum uric acid levels.
Body mass index (BMI), waist-to-hip ratio, serum uric acid, serum total cholesterol, low-density lipoprotein (LDL) cholesterol, triglycerides, very LDL cholesterol were significantly higher among diabetic patients compared to controls. On univariate analysis, serum LDL cholesterol (odds ratio [OR]: 29.67, P < 0.001), serum uric acid (OR: 25.65, P < 0.001), low high-density lipoprotein (HDL) cholesterol (OR: 21.12, P < 0.001), hypertension (OR: 17.06, P < 0.001), family history of cardiovascular disease (CVD) (OR: 9.43, P = 0.002), and duration of diabetes (OR: 4.65, P = 0.03) were identified as predictors of CVD among diabetic patients. On multivariate regression, only LDL cholesterol (OR: 1.51, P = 0.002) and serum uric acid (OR: 1.21, P = 0.01) were the independent predictors of CAD among diabetic patients. Significant positive correlation of serum uric acid with duration of diabetes (r = 0.38, P = 0.006), BMI (r = 0.35, P = 0.01), triglycerides (r = 0.356, P = 0.01), LDL cholesterol (r = 0.38, P = 0.007), HDL cholesterol (r = -0.514, P < 0.001), and hypertension (r = 0.524, P < 0.001) was observed.
Serum LDL cholesterol and hyperuricemia may serve as independent predictors of CAD among Asian Indian subjects with type 2 DM.
我们旨在确定2型糖尿病(2型DM)患者冠状动脉疾病(CAD)的预测因素。
本研究纳入了约50名年龄大于40岁的亚洲印度2型糖尿病患者以及50名性别和年龄匹配的非糖尿病对照者。记录完整病史和基线临床数据后,进行实验室检查以评估空腹和餐后血浆葡萄糖水平、血脂谱、血尿素、血清肌酐和血清尿酸水平。
与对照组相比,糖尿病患者的体重指数(BMI)、腰臀比、血清尿酸、血清总胆固醇、低密度脂蛋白(LDL)胆固醇、甘油三酯、极低密度脂蛋白胆固醇显著更高。单因素分析显示,血清LDL胆固醇(比值比[OR]:29.67,P<0.001)、血清尿酸(OR:25.65,P<0.001)、低高密度脂蛋白(HDL)胆固醇(OR:21.12,P<0.001)、高血压(OR:17.06,P<0.001)、心血管疾病(CVD)家族史(OR:9.43,P = 0.002)以及糖尿病病程(OR:4.65,P = 0.03)被确定为糖尿病患者CVD的预测因素。多因素回归分析显示,只有LDL胆固醇(OR:1.51,P = 0.002)和血清尿酸(OR:1.21,P = 0.01)是糖尿病患者CAD的独立预测因素。观察到血清尿酸与糖尿病病程(r = 0.38,P = 0.006)、BMI(r = 0.35,P = 0.01)、甘油三酯(r = 0.356,P = 0.01)、LDL胆固醇(r = 0.38,P = 0.007)、HDL胆固醇(r = -0.514,P<0.001)以及高血压(r = 0.524,P<0.001)之间存在显著正相关。
血清LDL胆固醇和高尿酸血症可能是亚洲印度2型糖尿病患者CAD的独立预测因素。