Impact of glycemic control on the association of endothelial dysfunction and coronary artery disease in patients with type 2 diabetes mellitus.
Impact of glycemic control on the association of endothelial dysfunction and coronary artery disease in patients with type 2 diabetes mellitus.
复制标题
血糖控制对 2 型糖尿病患者内皮功能障碍和冠状动脉疾病关联的影响
DOI：
10.1186/s12933-021-01257-y
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发表时间：
2021-03-13
影响因子：
9.3
通讯作者：
Ding FH
中科院分区：
文献类型：
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作者：
Chen S;Shen Y;Liu YH;Dai Y;Wu ZM;Wang XQ;Yang CD;Li LY;Liu JM;Zhang LP;Shen WF;Ji R;Lu L;Ding FH
我们研究了血糖控制是否会影响2型糖尿病（T2DM）患者内皮功能障碍与冠状动脉疾病之间的关系。
在102例患有稳定型心绞痛的2型糖尿病患者中，使用高分辨率超声检测肱动脉血流介导的舒张功能（FMD）来评估内皮功能，并确定主要心外膜冠状动脉的显著狭窄（直径狭窄≥50%）以及冠状动脉粥样硬化的程度（Gensini评分和SYNTAX评分）。通过糖化血红蛋白（HbA1c）的血液浓度来评估血糖控制状况。
与血糖控制良好（HbA1c<7.0%；n = 46）的糖尿病患者相比，血糖控制不佳（HbA1c≥7.0%；n = 56）的糖尿病患者中，显著冠状动脉狭窄的患病率（67.9%对37.0%，P = 0.002）和冠状动脉粥样硬化程度（Gensini评分：48.99 ± 48.88对15.07 ± 21.03，P<0.001；SYNTAX评分：15.88 ± 16.36对7.28 ± 10.54，P = 0.003）更高，而FMD更低（6.03 ± 2.08%对6.94 ± 2.20%，P = 0.036）。多变量回归分析显示，在血糖控制不佳的糖尿病患者中，FMD的三分位数是显著冠状动脉狭窄存在（OR = 0.227，95%CI 0.056 - 0.915，P = 0.037）、Gensini评分（β = -0.470，P<0.001）和SYNTAX评分（β = -0.349，P = 0.004）的独立决定因素，但在血糖控制良好的患者中并非如此（P>0.05）。
血糖控制不佳对2型糖尿病患者内皮功能障碍与冠状动脉疾病之间的关联产生负面影响。
We investigated whether glycemic control affects the relation between endothelial dysfunction and coronary artery disease in patients with type 2 diabetes mellitus (T2DM). In 102 type 2 diabetic patients with stable angina, endothelial function was evaluated using brachial artery flow-mediated dilation (FMD) with high-resolution ultrasound, and significant stenosis of major epicardial coronary arteries (≥ 50% diameter narrowing) and degree of coronary atherosclerosis (Gensini score and SYNTAX score) were determined. The status of glycemic control was assessed by blood concentration of glycated hemoglobin (HbA1c). The prevalence of significant coronary artery stenosis (67.9% vs. 37.0%, P = 0.002) and degree of coronary atherosclerosis (Gensini score: 48.99 ± 48.88 vs. 15.07 ± 21.03, P < 0.001; SYNTAX score: 15.88 ± 16.36 vs. 7.28 ± 10.54, P = 0.003) were higher and FMD was lower (6.03 ± 2.08% vs. 6.94 ± 2.20%, P = 0.036) in diabetic patients with poor glycemic control (HbA1c ≥ 7.0%; n = 56) compared to those with good glycemic control (HbA1c < 7.0%; n = 46). Multivariate regression analysis revealed that tertile of FMD was an independent determinant of presence of significant coronary artery stenosis (OR = 0.227 95% CI 0.056–0.915, P = 0.037), Gensini score (β = − 0.470, P < 0.001) and SYNTAX score (β = − 0.349, P = 0.004) in diabetic patients with poor glycemic control but not for those with good glycemic control (P > 0.05). Poor glycemic control negatively influences the association of endothelial dysfunction and coronary artery disease in T2DM patients.
DOI：
10.12659/msm.881390
发表时间：
2011-02
期刊：
Medical science monitor : international medical journal of experimental and clinical research
影响因子：
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作者：
Bissinger A;Grycewicz T;Grabowicz W;Lubiński A
通讯作者：
Lubiński A