Association of increased serum glycated albumin levels with low coronary collateralization in type 2 diabetic patients with stable angina and chronic total occlusion
Association of increased serum glycated albumin levels with low coronary collateralization in type 2 diabetic patients with stable angina and chronic total occlusion
复制标题
患有稳定型心绞痛和慢性完全闭塞的 2 型糖尿病患者血清糖化白蛋白水平升高与冠状动脉侧支化低之间的关系
DOI：
10.1186/1475-2840-12-165
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发表时间：
2013-11-08
影响因子：
9.3
通讯作者：
Shen, Wei Feng
中科院分区：
文献类型：
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作者：
Shen, Ying;Lu, Lin;Shen, Wei Feng
背景：我们探讨了2型糖尿病慢性完全闭塞患者血清糖化白蛋白(GA)水平与冠状动脉侧支循环的关系。方法：检测317例稳定性心绞痛患者和117例非糖尿病患者的血糖化白蛋白(GA)和糖化血红蛋白(HbA1c)水平。从对侧血管供应完全闭塞远端的侧支程度分为低侧支(Rtrop评分0或1)或高侧支(Rtrop评分2或3)。结果：糖尿病患者GA(21.2+/-6.5%比18.7+/-5.6%，P<；0.001)，但未见HbA1c水平(7.00±1.1%vs.6.8±1.3%，P=0.27)，且与Rtrop评分呈负相关(P<0.001)。GA曲线下面积较HbA1c曲线下面积大(0.64比0.58，P=0.15)。在非糖尿病患者中，无论冠状动脉侧支状态如何，GA和HbA1c水平均无显著差异。在多变量分析中，女性、年龄65岁、吸烟、非高血压、糖尿病病程10年、代谢综合征、EGFR、90ml/min/1.73m(2)、GA>；18.3%是糖尿病患者侧支循环减少的独立危险因素。结论：血清GA水平升高与稳定性心绞痛和慢性完全闭塞的2型糖尿病患者侧支循环发育受损有关。
Background: We investigated whether serum glycated albumin (GA) levels are related to coronary collateralization in type 2 diabetic patients with chronic total occlusion.Methods: Blood levels of GA and glycosylated hemoglobin (HbA1c) were determined in 317 diabetic and 117 non-diabetic patients with stable angina and angiographic total occlusion of at least one major coronary artery. The degree of collaterals supplying the distal aspect of a total occlusion from the contra-lateral vessel was graded as low (Rentrop score of 0 or 1) or high collateralization (Rentrop score of 2 or 3).Results: For diabetic patients, GA (21.2 +/- 6.5% vs. 18.7 +/- 5.6%, P < 0.001) but not HbA1c levels (7.0 +/- 1.1% vs. 6.8 +/- 1.3%, P = 0.27) was significantly elevated in low collateralization than in high collateralization group, and correlated inversely with Rentrop score (Spearmen's r = -0.28, P < 0.001; Spearmen's r = -0.10, P = 0.09, respectively). There was a trend towards a larger area under the curve of GA compared with that of HbA1c for detecting the presence of low collateralization (0.64 vs. 0.58, P = 0.15). In non-diabetic patients, both GA and HbA1c levels did not significantly differ regardless the status of coronary collateralization. In multivariable analysis, female gender, age > 65 years, smoke, non-hypertension, duration of diabetes > 10 years, metabolic syndrome, eGFR < 90 ml/min/1.73 m(2), and GA > 18.3% were independently determinants for low collateralization in diabetic patients.Conclusions: Increased GA levels in serum are associated with impaired collateral growth in type 2 diabetic patients with stable angina and chronic total occlusion.