非糖尿病患者糖化血红蛋白和胰岛素抵抗与冠状动脉病变程度的相关性研究(1)
摘 要：目的 研究非糖尿病的冠心病患者中糖化血红蛋白(HbA1c)和胰岛素抵抗与冠状动脉病变严重程度的关系。方法 纳入临床疑诊冠心病并接受冠状动脉造影的非糖尿病患者184例，依据SYNTAX积分分为轻度狭窄组(0～22分)60例、中度狭窄组(23～32分)76例、重度狭窄组(≥33分)48例，采用Pearson相关性分析及多元线性逐步回归分析SYNTAX积分与HbA1c水平、稳态模型胰岛素抵抗指数(HOMA-IR)的关系。结果 三组间年龄、吸烟史、TC、LDL-C、HbA1c、HOMA-IR及CRP水平差异有统计学意义(P<0.05)。相关性分析显示SYNTAX积分与HbA1c、HOMA-IR及CRP水平呈正相关，HbA1c与HOMA-IR呈正相关，多元线性逐步回归分析显示年龄、吸烟、HbA1c、HOMA-IR及CRP与冠脉病变程度独立相关。结论 在非糖尿病的冠心病人群中存在胰岛素抵抗，且胰岛素抵抗、HbA1c水平与冠状动脉病变严重程度密切相关。
关键词：冠心病；糖化血红蛋白；胰岛素抵抗；SYNTAX积分
, 百拇医药
中图分类号：R541.4 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.10.028
文章编号：1006-1959(2018)10-0093-04
Correlation between Glycosylated Hemoglobin and Insulin Resistance and Severity of Coronary Artery Disease in Non-diabetic Patients
YANG Jin-long1，LIU Huan2，LV Qiu-ju2，ZHANG Jin2
(Department of Cardiology1，Department of Endocrinology2，Leshan City People's Hospital，Leshan 614000，Sichuan，China)
, 百拇医药
Abstract：Objective To study the relationship between glycosylated hemoglobin(HbA1c)and insulin resistance and severity of coronary artery disease in non-diabetic patients with coronary heart disease.Methods Among 184 non-diabetic patients with suspected coronary heart disease who underwent coronary angiography，according to SYNTAX scores，60 patients with mild stenosis(0 to 22 points)，76 patients with moderate stenosis(23 to 32 points)，In 48 patients with severe stenosis group(≥33 points)，Pearson correlation analysis and multiple linear stepwise regression were used to analyze the relationship between SYNTAX scores and HbA1c level and homeostasis model insulin resistance index(HOMA-IR).Results There was significant difference in age，smoking history，TC， LDL-C，HbA1c，HOMA-IR and CRP levels among the three groups(P<0.05).Correlation analysis showed that SYNTAX scores was positively correlated with HbA1c，HOMA-IR，and CRP levels，and HbA1c was positively correlated with HOMA-IR.Multiple linear stepwise regression analysis showed that age， smoking，HbA1c，HOMA-IR，and CRP were independently associated with the degree of coronary artery disease.Conclusion Insulin resistance exists in non-diabetic patients with coronary heart disease，and insulin resistance and HbA1c levels are closely related to the severity of coronary artery disease.
Key words：Coronary heart disease；Glycosylated hemoglobin；Insulin resistance；SYNTAX scores
近年來在如何预防冠状动脉粥样硬化疾病(CAD)的大量研究中一再强调，糖尿病患者这一人群应当积极预防动脉粥样硬化的必要性，其中很多研究靶点集中于胰岛素抵抗和高血糖症对动脉粥样硬化的影响[1]。然而，迄今关于胰岛素抵抗及糖化血红蛋白(HbA1c)与非糖尿病患者的冠心病发生风险及严重程度尚不完全明确。为此，我们通过选取临床上疑诊为冠心病而接受冠状动脉造影的非糖尿病患者，探讨冠状动脉狭窄程度与HbA1c水平、胰岛素抵抗的关系。, 百拇医药(杨锦龙 刘欢 吕秋菊)
关键词：冠心病；糖化血红蛋白；胰岛素抵抗；SYNTAX积分
, 百拇医药
中图分类号：R541.4 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.10.028
文章编号：1006-1959(2018)10-0093-04
Correlation between Glycosylated Hemoglobin and Insulin Resistance and Severity of Coronary Artery Disease in Non-diabetic Patients
YANG Jin-long1，LIU Huan2，LV Qiu-ju2，ZHANG Jin2
(Department of Cardiology1，Department of Endocrinology2，Leshan City People's Hospital，Leshan 614000，Sichuan，China)
, 百拇医药
Abstract：Objective To study the relationship between glycosylated hemoglobin(HbA1c)and insulin resistance and severity of coronary artery disease in non-diabetic patients with coronary heart disease.Methods Among 184 non-diabetic patients with suspected coronary heart disease who underwent coronary angiography，according to SYNTAX scores，60 patients with mild stenosis(0 to 22 points)，76 patients with moderate stenosis(23 to 32 points)，In 48 patients with severe stenosis group(≥33 points)，Pearson correlation analysis and multiple linear stepwise regression were used to analyze the relationship between SYNTAX scores and HbA1c level and homeostasis model insulin resistance index(HOMA-IR).Results There was significant difference in age，smoking history，TC， LDL-C，HbA1c，HOMA-IR and CRP levels among the three groups(P<0.05).Correlation analysis showed that SYNTAX scores was positively correlated with HbA1c，HOMA-IR，and CRP levels，and HbA1c was positively correlated with HOMA-IR.Multiple linear stepwise regression analysis showed that age， smoking，HbA1c，HOMA-IR，and CRP were independently associated with the degree of coronary artery disease.Conclusion Insulin resistance exists in non-diabetic patients with coronary heart disease，and insulin resistance and HbA1c levels are closely related to the severity of coronary artery disease.
Key words：Coronary heart disease；Glycosylated hemoglobin；Insulin resistance；SYNTAX scores
近年來在如何预防冠状动脉粥样硬化疾病(CAD)的大量研究中一再强调，糖尿病患者这一人群应当积极预防动脉粥样硬化的必要性，其中很多研究靶点集中于胰岛素抵抗和高血糖症对动脉粥样硬化的影响[1]。然而，迄今关于胰岛素抵抗及糖化血红蛋白(HbA1c)与非糖尿病患者的冠心病发生风险及严重程度尚不完全明确。为此，我们通过选取临床上疑诊为冠心病而接受冠状动脉造影的非糖尿病患者，探讨冠状动脉狭窄程度与HbA1c水平、胰岛素抵抗的关系。, 百拇医药(杨锦龙 刘欢 吕秋菊)