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冠心病心绞痛患者残胆固醇检测用于糖代谢状态的研究。

Remnant cholesterol for the detection of glucose metabolic states in patients with coronary heart disease angina pectoris.

机构信息

Tianjin University of Traditional Chinese Medicine, Tianjin, 301617, China.

First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, 300381, China.

出版信息

Acta Diabetol. 2022 Oct;59(10):1339-1347. doi: 10.1007/s00592-022-01935-7. Epub 2022 Jul 23.

Abstract

BACKGROUND

This study aimed to evaluate the relationship between remnant cholesterol (RC) and glucose metabolic states in coronary heart disease (CHD) patients with angina pectoris.

METHODS

This study collected data from 11,557 CHD patients with angina pectoris aged 35-75 years in Tianjin, China. Participants were divided into normal glucose regulation (NGR), prediabetes (Pre-DM) and diabetes mellitus (DM) groups according to glucose metabolic states. Linear regression analysis was used to explore the relationship between glucose metabolism [fasting blood glucose (FBG) and glycated hemoglobin (HbA1c)] and RC levels. Logistic regression was performed to analyze the relationship between RC levels and glucose metabolic states.

RESULTS

Among all participants, 5883 (50.9%) had a DM state and 4034 (34.9%) had a Pre-DM state. FBG levels and HbA1c levels were positively related with RC in all patients (P < 0.001). NGR was used as a reference, multi-adjusted model showing that RC level was significantly associated with Pre-DM [Odds ratio (OR): 1.37; 95% confidence interval (CI) 1.19-1.56; P < 0.001] and DM state (OR:1.47; 95% CI 1.29-1.67; P < 0.001). When considering RC as categorical variables (tertiles), using T1 as a reference, T3 had the strongest relationship between RC levels and Pre-DM and DM state in univariate model and multivariate model. In the stratified analyses, the association between RC levels and pre-DM and DM in women was higher than that in men, and the elderly patients was higher than in the middle-aged patients.

CONCLUSION

The study demonstrated a significant association between RC levels and pre-DM and DM state among CHD patients with angina pectoris, and the relationship was stronger in women and elderly patients.

摘要

背景

本研究旨在评估冠心病心绞痛患者残余胆固醇(RC)与糖代谢状态之间的关系。

方法

本研究在中国天津收集了 11557 名年龄在 35-75 岁的冠心病心绞痛患者的数据。根据糖代谢状态,将参与者分为正常血糖调节(NGR)、糖尿病前期(Pre-DM)和糖尿病(DM)组。采用线性回归分析探讨糖代谢[空腹血糖(FBG)和糖化血红蛋白(HbA1c)]与 RC 水平之间的关系。采用 logistic 回归分析 RC 水平与糖代谢状态的关系。

结果

在所有参与者中,5883 人(50.9%)处于 DM 状态,4034 人(34.9%)处于 Pre-DM 状态。FBG 水平和 HbA1c 水平与所有患者的 RC 呈正相关(P<0.001)。以 NGR 为参照,多因素调整模型显示,RC 水平与 Pre-DM 显著相关[比值比(OR):1.37;95%置信区间(CI):1.19-1.56;P<0.001]和 DM 状态(OR:1.47;95% CI:1.29-1.67;P<0.001)。当考虑 RC 为分类变量(三分位数)时,在单变量模型和多变量模型中,以 T1 为参照,T3 与 Pre-DM 和 DM 状态之间的 RC 水平相关性最强。在分层分析中,RC 水平与女性的 Pre-DM 和 DM 之间的关联高于男性,老年患者高于中年患者。

结论

本研究表明,冠心病心绞痛患者 RC 水平与 Pre-DM 和 DM 状态显著相关,且在女性和老年患者中更为显著。

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