Correlation between glycosylated hemoglobin level and coronary heart disease in patients with and with-out diabetes mellitus / 心血管康复医学杂志

ABSTRACT

Objective:To study the correlation between glycosylated hemoglobin (HbA1c) level and coronary heart disease (CHD) in patients with and without diabetes mellitus (DM) .Methods:A total of 100 DM patients and 100 non-DM patients were enrolled .According to complicated CHD or not ,DM patients were divided into DM +CHD group (n=44) and DM + non-CHD group (n=56) ,non-DM patients were divided into non -DM + CHD group (n=41) and non-DM + non-CHD group (n=59) .HbA1c concentration ,insulin resistance [homeostasis model-insulin resistance index (HOMA-IR) ,insulin sensitivity index (ISI)] and endothelial function [number of endothelial microparticles (EMPs) ,brachial artery flow -mediated dilation (FMD)] were measured and compared among above groups .Results:Compared with DM + non-CHD group ,there were significant rise in HbA1c con‐centration [ (7.10 ± 0.86)% vs .(9.98 ± 1.05)% ] ,HOMA-IR [ (2.28 ± 0.31) vs .(3.31 ± 0.52)] and number of EMPs [(548.29 ± 69.35)/μl vs . (861.18 ± 94.57) /μl] ,and significant reductions in ISI [(-3.23 ± 0.41) vs .(-4.62 ± 0.65)] and FMD [ (6.65 ± 0.75)% vs .(4.58 ± 0.59)% ] in DM + CHD group , P<0.05 all .Compared with non -DM + non-CHD group ,there were significant rise in HbA1c concentration ,HOMA-IR and number of EMPs ,and significant reductions in ISI and FMD in non -DM + CHD group , P<0.05 or <0.01 .Single factor regression analysis indicated that HbA1c level was positively correlated with HOMA -IR and number of EMPs (β=2.845 ,1.945 , P<0.05 both) ,and inversely correlated with ISI and FMD (β= -3.582 ,-3.293 , P<0.05 both) . Conclusion:In patients with or without diabetes mellitus ,glycosylated hemoglobin concentration significantly rising can cause insulin resistance ,endothelial function injury ,then further lead to occurrence of coronary heart disease .