极低密度脂蛋白胆固醇与2型糖尿病患者冠状动脉疾病的范围和严重程度相关。
Very low-density lipoprotein cholesterol is associated with extent and severity of coronary artery disease in patients with type 2 diabetes mellitus.
作者信息
Jia Aimei, Zeng Wei, Yu Liuqin, Zeng Huirun, Lu Zhan, Song Yongyan
机构信息
School of Preclinical Medicine and Nanchong Key Laboratory of Metabolic Drugs and Biological Products, North Sichuan Medical College, Nanchong, People's Republic of China.
Department of Cardiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, People's Republic of China.
出版信息
SAGE Open Med. 2019 Aug 23;7:2050312119871786. doi: 10.1177/2050312119871786. eCollection 2019.
OBJECTIVE
Patients with type 2 diabetes mellitus usually have multiple cardiovascular disease risk factors. The objective of this study was to examine the severity and associated risk factors in coronary artery disease patients with type 2 diabetes mellitus.
METHODS
Two hundred and five coronary artery disease patients with type 2 diabetes mellitus and 205 age-, gender- and smoking-matched coronary artery disease patients without type 2 diabetes mellitus were recruited from the Department of Cardiology of our hospital. Demographic and clinical data were collected for all participants. Severity of coronary artery disease was assessed using Gensini scoring system, the number of diseased coronary arteries, and the extent of coronary stenosis.
RESULTS
Coronary artery disease patients with type 2 diabetes mellitus had higher Gensini scores (p < 0.01), more numbers of diseased coronary arteries (p < 0.001), and higher degrees of coronary stenosis (p = 0.05) than coronary artery disease patients without type 2 diabetes mellitus. The plasma levels of very low-density lipoprotein cholesterol (p < 0.001) and triglycerides (p < 0.001) were also higher in coronary artery disease patients with type 2 diabetes mellitus than in coronary artery disease patients without type 2 diabetes mellitus. In coronary artery disease patients with type 2 diabetes mellitus, very low-density lipoprotein cholesterol was positively correlated with Gensini scores (r = 0.15, p = 0.03), the number of diseased coronary arteries (r = 0.15, p = 0.04), and the extent of coronary stenosis (r = 0.14, p = 0.05) by partial correlation analysis after controlling for other lipid parameters, and independently associated with Gensini scores (beta = 0.18, p = 0.02) and the number of diseased coronary arteries (odds ratio = 2.09, p = 0.05) after adjusting for other cardiovascular risk factors in the following multiple regression analysis.
CONCLUSION
Very low-density lipoprotein cholesterol may represent a marker for the severity of coronary artery disease and be a target for the treatment in diabetic patients. Further research is needed to determine whether very low-density lipoprotein cholesterol plays a causal role of coronary artery disease in diabetic patients.
目的
2型糖尿病患者通常有多种心血管疾病风险因素。本研究的目的是探讨2型糖尿病合并冠状动脉疾病患者的病情严重程度及相关危险因素。
方法
从我院心内科招募了205例2型糖尿病合并冠状动脉疾病患者以及205例年龄、性别和吸烟情况相匹配的非2型糖尿病冠状动脉疾病患者。收集了所有参与者的人口统计学和临床资料。使用Gensini评分系统、病变冠状动脉数量和冠状动脉狭窄程度来评估冠状动脉疾病的严重程度。
结果
与非2型糖尿病冠状动脉疾病患者相比，2型糖尿病合并冠状动脉疾病患者的Gensini评分更高（p<0.01），病变冠状动脉数量更多（p<0.001），冠状动脉狭窄程度更高（p=0.05）。2型糖尿病合并冠状动脉疾病患者的血浆极低密度脂蛋白胆固醇水平（p<0.001）和甘油三酯水平（p<0.001）也高于非2型糖尿病冠状动脉疾病患者。在2型糖尿病合并冠状动脉疾病患者中，在控制其他血脂参数后，通过偏相关分析发现极低密度脂蛋白胆固醇与Gensini评分（r=0.15，p=0.03）、病变冠状动脉数量（r=0.15，p=0.04）和冠状动脉狭窄程度（r=0.14，p=0.05）呈正相关，并且在随后的多元回归分析中，在调整其他心血管危险因素后，与Gensini评分（β=0.18，p=0.02）和病变冠状动脉数量（比值比=2.09，p=0.05）独立相关。
结论
极低密度脂蛋白胆固醇可能是冠状动脉疾病严重程度的一个标志物，并且是糖尿病患者治疗的一个靶点。需要进一步研究以确定极低密度脂蛋白胆固醇在糖尿病患者冠状动脉疾病中是否起因果作用。
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