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目的探讨糖化白蛋白与糖尿病并发冠心病的关系。方法测定349例糖尿病患者和340例正常对照者的血清糖化白蛋白和糖化血红蛋白浓度。糖尿病患者根据冠状动脉造影管腔直径狭窄是否超过70%分为冠状动脉非显著狭窄组(n=166)和显著狭窄组(n=183)。采用多元回归分析判断糖尿病患者冠状动脉显著狭窄的独立危险因素。结果冠状动脉显著狭窄组血清糖化白蛋白浓度显著高于非显著狭窄组和对照组(P<0.01)。血清糖化白蛋白浓度与冠状动脉血管病变数呈显著相关(r=0.19,P<0.01)。但冠状动脉非显著狭窄组和显著狭窄组之间糖化血红蛋白浓度无统计学差异。多元回归分析发现年龄≥65岁、男性、血清糖化白蛋白浓度、脂蛋白(a)和高血压是糖尿病并发冠心病的独立危险因素。结论糖尿病患者糖化白蛋白水平与冠心病发生及病变严重程度显著相关,是并发冠心病的独立危险因素。
Objective To investigate the relationship between glycated albumin and coronary heart disease in patients with diabetes mellitus. Methods Serum levels of glycosylated albumin and glycosylated hemoglobin were measured in 349 diabetics and 340 normal controls. Diabetic patients were divided into non-significant coronary artery stenosis group (n = 166) and significant stenosis group (n = 183) according to whether coronary artery stenosis was more than 70%. Multiple regression analysis was used to identify independent risk factors for significant coronary stenosis in diabetic patients. Results Serum glycosylated albumin concentration in stenosis group was significantly higher than that in nonsignificant stenosis group and control group (P <0.01). Serum glycated albumin concentration and coronary artery disease was significantly correlated (r = 0.19, P <0.01). However, there was no significant difference in HbA1c between nonsignificant stenosis group and stenosis group. Multivariate regression analysis found that age ≥65 years, male, serum albumin concentration, lipoprotein (a) and hypertension were independent risk factors for diabetic patients with coronary heart disease. Conclusions The level of glycated albumin in diabetic patients is significantly correlated with the occurrence and severity of coronary heart disease and is an independent risk factor for coronary heart disease.