未診斷糖尿病的冠心病患者糖代謝狀況分析_《中國循證醫學雜志》

作者：

溫主治 ¹ , 張嵐 ² , 張亞梅 ¹ , 王景峰 ¹ ,  耿登峰 ¹

1. 廣州市中山大學第二附屬醫院心內科（廣州?510120）；2. 廣東省榮譽軍人康復醫院（廣州市?510260）;

關鍵詞：

冠脈造影冠心病糖代謝異常糖尿病口服葡萄糖耐量試驗

DOI：

10.7507/1672-2531.20100515

視頻：

導出 下載 收藏 掃碼 引用

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

目的 ?探討未診斷糖尿病但經冠脈造影確診的冠心病住院患者（CAD）的糖代謝狀況。
方法 ?采用橫斷面研究設計，納入2007年1月至2009年5月在中山大學附二院心血管內科住院的患者499例，根據冠脈造影結果分為冠心病組和非冠心病組，比較兩組的糖代謝異常情況。
結果 ?兩組隨機血糖（RPG）和空腹血糖（FPG）差異無統計學意義（P值分別為0.249和0.444），但OGTT 2小時血糖（2hPG）在冠心病組明顯升高，差異有統計學意義（P lt;0.001）；冠心病組糖代謝異常患病率達74.0%，其中新診斷糖尿病32.1%，糖耐量異常（IGT）39.0%，分別高于非冠心病組的61.6%、36.0%和20.7%，兩組差異有統計學意義（P=0.006）。logistic回歸分析提示，冠心病組患者存在糖耐量異常和新診斷糖尿病的風險分別是非冠心病組患者的1.6倍［OR=1.603，95%CI（1.023，2.512），P=0.04］和2.3倍［OR=2.292，95%CI（1.391，3.777），P=0.001］，在糾正高血壓、血脂異常、BMI、hs-CRP等因素后，冠心病組患者存在新診斷糖尿病風險仍較非冠心病組患者明顯升高［OR=1.852，95%CI（1.064，3.223），P=0.029］。
結論 ?未診斷糖尿病的冠心病住院患者普遍存在糖代謝異常，這些患者大部分需要通過OGTT檢查才能及時準確地診斷。OGTT應該作為發現冠心病住院患者糖代謝異常的常規檢查項目，如可能，全部心血管住院患者均應常規行OGTT檢查。

引用本文： 溫主治,張嵐,張亞梅,王景峰,耿登峰. 未診斷糖尿病的冠心病患者糖代謝狀況分析. 中國循證醫學雜志, 2010, 10(8): 892-896. doi: 10.7507/1672-2531.20100515 復制

1.	Hu DY, Pan CY, Yu JM, for the China Heart Survey Group. The relationship between coronary artery disease and abnormal glucose regulation in China: the China Heart Survey. Eur Heart J, 2006, 27: 2573-2579.
2.	Bartnik M, Ryden L, Ferrari R, et al. The prevalence of abnormal glucose regulation in patients with coronary artery disease across Europe: the Euro Heart Survey on diabetes and the heart. Eur Heart J, 2004, 25: 1880-1890.
3.	Stern MP. Diabetes and cardiovascular disease. The "common soil" hypothesis. Diabetes, 1995, 44(4): 369-374.
4.	Barr EL, Zimmet PZ, Welborn TA, et al. Risk of Cardiovascular and All-Cause Mortality in Individuals With Diabetes Mellitus, Impaired Fasting Glucose, and Impaired Glucose Tolerance The Australian Diabetes, Obesity, and Lifestyle Study (AusDiab). Circulation, 2007, 116: 151-157.
5.	Norhammar A, Malmberg K, Diderholm E, et al. Diabetes mellitus: The major risk factor in unstable coronary artery disease even after consideration of the extent of coronary artery disease and benefits of revascularization. J Am Coll Cardiol, 2004, 43: 585-591.
6.	Tamita K, Katayama M, Takagi T, et al. Impact of Newly Diagnosed Abnormal Glucose Tolerance on Long-Term Prognosis in Patients With Acute Myocardial Infarction. Circ J, 2007, 71: 834-841.
7.	DECODE Study Group, the European Diabetes Epidemiology Group. Glucose tolerance and cardiovascular mortality: Comparison of fasting and 2-hour diagnostic criteria. Arch Intern Med, 2001, 161: 397-405.
8.	Pan XR, Li GW, Hu YH, et al. Effects of diet and exercise in preventing NIDDM in people with impaired glucose tolerance. The Da Qing IGT and Diabetes Study. Diabetes Care,1997, 20: 537-544.
9.	Chiasson JL, Josse RG, Gomis R, et al. Acarbose treatment and the risk of cardiovascular disease and hypertension in patients with impaired glucose tolerance: The STOPNIDDM trial. JAMA, 2003, 290: 486-494.
10.	Bartnik M, Ryde´n L, Malmberg KO, et al. on behalf of the Euro Heart Survey Investigators. Oral glucose tolerance test is needed for appropriate classification of glucose regulation in patients with coronary artery disease. Heart, 2007, 93: 72-77.

1. Hu DY, Pan CY, Yu JM, for the China Heart Survey Group. The relationship between coronary artery disease and abnormal glucose regulation in China: the China Heart Survey. Eur Heart J, 2006, 27: 2573-2579.
2. Bartnik M, Ryden L, Ferrari R, et al. The prevalence of abnormal glucose regulation in patients with coronary artery disease across Europe: the Euro Heart Survey on diabetes and the heart. Eur Heart J, 2004, 25: 1880-1890.
3. Stern MP. Diabetes and cardiovascular disease. The "common soil" hypothesis. Diabetes, 1995, 44(4): 369-374.
4. Barr EL, Zimmet PZ, Welborn TA, et al. Risk of Cardiovascular and All-Cause Mortality in Individuals With Diabetes Mellitus, Impaired Fasting Glucose, and Impaired Glucose Tolerance The Australian Diabetes, Obesity, and Lifestyle Study (AusDiab). Circulation, 2007, 116: 151-157.
5. Norhammar A, Malmberg K, Diderholm E, et al. Diabetes mellitus: The major risk factor in unstable coronary artery disease even after consideration of the extent of coronary artery disease and benefits of revascularization. J Am Coll Cardiol, 2004, 43: 585-591.
6. Tamita K, Katayama M, Takagi T, et al. Impact of Newly Diagnosed Abnormal Glucose Tolerance on Long-Term Prognosis in Patients With Acute Myocardial Infarction. Circ J, 2007, 71: 834-841.
7. DECODE Study Group, the European Diabetes Epidemiology Group. Glucose tolerance and cardiovascular mortality: Comparison of fasting and 2-hour diagnostic criteria. Arch Intern Med, 2001, 161: 397-405.
8. Pan XR, Li GW, Hu YH, et al. Effects of diet and exercise in preventing NIDDM in people with impaired glucose tolerance. The Da Qing IGT and Diabetes Study. Diabetes Care,1997, 20: 537-544.
9. Chiasson JL, Josse RG, Gomis R, et al. Acarbose treatment and the risk of cardiovascular disease and hypertension in patients with impaired glucose tolerance: The STOPNIDDM trial. JAMA, 2003, 290: 486-494.
10. Bartnik M, Ryde´n L, Malmberg KO, et al. on behalf of the Euro Heart Survey Investigators. Oral glucose tolerance test is needed for appropriate classification of glucose regulation in patients with coronary artery disease. Heart, 2007, 93: 72-77.

《中國循證醫學雜志》

未診斷糖尿病的冠心病患者糖代謝狀況分析

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

上一篇

下一篇

Format

Content

《中國循證醫學雜志》

未診斷糖尿病的冠心病患者糖代謝狀況分析

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

上一篇

下一篇

Format

Content

摘要全文圖表視頻參考文獻施引文獻補充材料