在约旦一家转诊医院接受择期冠状动脉造影的患者中，空腹血糖升高而非肥胖与冠状动脉疾病相关。

Elevated fasting blood glucose, but not obesity, is associated with coronary artery disease in patients undergoing elective coronary angiography in a referral hospital in Jordan.

作者信息

Al-Shudifat Abdel-Ellah, Azab Mohammed, Johannessen Asgeir, Al-Shdaifat Amjad, Agraib Lana M, Tayyem Reema F

机构信息

Dr. Abdel-Ellah Al-Shudifat, Faculty of Medicine, Department of Internal Medicine,, The Hashemite University,, Zarqa, Jordan, T: +962 796004849,

出版信息

Ann Saudi Med. 2018 Mar-Apr;38(2):111-117. doi: 10.5144/0256-4947.2018.111.

DOI:10.5144/0256-4947.2018.111

PMID:29620544

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6074363/

Abstract

BACKGROUND

Obesity and its metabolic complications are endemic in the Middle East, but the cardiovascular consequences are not well defined in local studies.

OBJECTIVE

To assess the association between fasting blood glucose (FBG), obesity and coronary artery disease (CAD) in Jordan.

DESIGN

A cross-sectional, hospital-based study.

SETTING

A referral hospital in Amman, Jordan.

PATIENTS AND METHODS

Patients with complete anthropomorphic data who were referred for elective coronary angiography were included in the analysis. Associations between CAD, FBG and obesity were assessed in multivariate logistic regression models, adjusting for known risk factors.

MAIN OUTCOME MEASURE

The presence of CAD.

SAMPLE SIZE

434 subjects.

RESULTS

Only those who underwent coronary angiography and had complete anthropometric data were included in the study: 291 (67.1%) had CAD and 143 (32.9%) had a normal coronary angiogram.The mean body mass index, waist circumference and FBG of the study participants was 30.0 kg/m2, 106.0 cm and 8.8 mmol/L, respectively. The mean FBG was significantly higher in patients with CAD compared to those without CAD (9.5 vs. 7.3 mmol/L, P less than .001). Waist circumference was significantly higher in women with CAD compared to women without CAD (111.0 vs. 105.9 cm, P=.036), but no significant difference was observed in men. In a multivariate analysis, FBG was a strong and significant predictor of CAD; however, none of the measures of obesity were significantly associated with CAD. The findings were robust in a sensitivity analysis that excluded patients with known diabetes mellitus.

CONCLUSIONS

Elevated FBG, but not obesity, predicted CAD in a Middle Eastern population. Improved prevention, detection and management of type 2 diabetes should be a priority in this setting.

LIMITATIONS

The cross-sectional design cannot control for temporal changes in risk factors and/or reverse causation.

CONFLICT OF INTEREST

None.

摘要

背景

肥胖及其代谢并发症在中东地区很普遍，但当地研究对其心血管后果的界定并不明确。

目的

评估约旦空腹血糖（FBG）、肥胖与冠状动脉疾病（CAD）之间的关联。

设计

一项基于医院的横断面研究。

地点

约旦安曼的一家转诊医院。

患者与方法

分析纳入了因择期冠状动脉造影而转诊且具有完整人体测量数据的患者。在多因素逻辑回归模型中评估CAD、FBG与肥胖之间的关联，并对已知风险因素进行校正。

主要观察指标

CAD的存在情况。

样本量

434名受试者。

结果

本研究仅纳入了接受冠状动脉造影且具有完整人体测量数据的患者：291例（67.1%）患有CAD，143例（32.9%）冠状动脉造影正常。研究参与者的平均体重指数、腰围和FBG分别为30.0kg/m²、106.0cm和8.8mmol/L。与无CAD的患者相比，CAD患者的平均FBG显著更高（9.5 vs. 7.3mmol/L，P<0.001）。与无CAD的女性相比，患有CAD的女性腰围显著更高（111.0 vs. 105.9cm，P = 0.036），但男性未观察到显著差异。在多因素分析中，FBG是CAD的一个强有力的显著预测因素；然而，肥胖的各项指标均与CAD无显著关联。在排除已知糖尿病患者的敏感性分析中，研究结果依然稳健。