Significant coronary stenosis in asymptomatic Chinese with different glycemic status.
Significant coronary stenosis in asymptomatic Chinese with different glycemic status.
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DOI：
10.2337/dc12-0977
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发表时间：
2013-06
期刊：
影响因子：
16.2
通讯作者：
Ning G
中科院分区：
文献类型：
--
作者：
Xu Y;Bi Y;Li M;Wang T;Sun K;Xu M;Lu J;Yu Y;Li X;Lai S;Wang W;Ning G
评估中国社区成年人中无心肌缺血症状的早期糖尿病或糖尿病前期的冠状动脉狭窄。 从 40-60 岁的中国社区人口中随机挑选年龄和性别匹配、血糖调节正常 (NGR)、糖尿病前期或 5 年内诊断为糖尿病、无冠状动脉疾病 (CAD) 症状的参与者。双源计算机断层扫描冠状动脉造影用于评估冠状动脉狭窄的存在和程度，如果检测到血管腔狭窄> 50％，则认为冠状动脉狭窄是显着的。 排除由于运动伪影导致的无法解释的片段后，共有 135 名 NGR 参与者、132 名糖尿病前期参与者和 134 名糖尿病参与者参与了数据分析。分别有 10 名 (7.4%)、10 名 (7.6%) 和 22 名 (16.4%) 患有 NGR、糖尿病前期和糖尿病的个体检测到显着冠状动脉狭窄（趋势 P = 0.029）。糖尿病（而非糖尿病前期）与显着升高 2.34 倍的风险相关[比值比 (OR) 2.34 (95% CI 1.01–5.43)；与 NGR 相关的冠状动脉狭窄相比，P = 0.047]。血糖评估水平与糖尿病患者冠状动脉严重狭窄的风险独立且显着相关。在调整其他传统心血管危险因素后，空腹血糖、2小时负荷后血糖和HbA1c每增加1-SD，显着冠状动脉狭窄的风险分别增加2.11倍、1.73倍和1.81倍。使用双源计算机断层扫描冠状动脉造影等无创 CAD 诊断方式，我们发现无症状的中国成年人患早期糖尿病的严重冠状动脉狭窄风险显着升高。
To evaluate coronary artery stenosis in early diabetes or prediabetes asymptomatic of myocardial ischemia in community-dwelling Chinese adults. Age- and sex-matched participants with normal glucose regulation (NGR), prediabetes, or diabetes diagnosed within 5 years, asymptomatic of coronary artery disease (CAD), were randomly selected from a community-dwelling Chinese population aged 40–60 years. Dual-source computed tomography coronary angiography was used to evaluate the existence and extent of coronary stenosis, which was considered significant if >50% narrowing of vessel lumen was detected. After excluding uninterpretable segments attributable to motion artifacts, a total of 135 participants with NGR, 132 with prediabetes, and 134 with diabetes participated in data analysis. Significant coronary stenosis was detected in 10 (7.4%), 10 (7.6%), and 22 (16.4%) individuals with NGR, prediabetes, and diabetes, respectively (P for trend = 0.029). Diabetes, rather than prediabetes, was associated with a significant 2.34-fold elevated risk [odds ratio (OR) 2.34 (95% CI 1.01–5.43); P = 0.047] of significant coronary stenosis as compared with that associated with NGR. Levels of glucose evaluation were independently and significantly associated with risks of significant coronary stenosis in diabetes. Each 1-SD increase in fasting plasma glucose, 2-h postload plasma glucose, and HbA1c conveyed 2.11-fold, 1.73-fold, and 1.81-fold higher risks of significant coronary stenosis, respectively, after adjustment for other conventional cardiovascular risk factors. Using a noninvasive CAD diagnostic modality such as dual-source computed tomography coronary angiography, we detected a markedly elevated risk of significant coronary stenosis with early diabetes in asymptomatic Chinese adults.
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