Correlation between coronary artery lesion and insulin resistance in patients with coronary heart disease combined with type 2 diabetes mellitus

doi:10.3969/j.issn.1004-583X.2023.01.005

Abstract

Abstract:

Objective To investigate the correlation between the ischemic degree of coronary artery and calcification and insulin resistance in patients with coronary heart disease combined with type 2 diabetes mellitus (T2DM). Methods From January 1, 2020 to January 1, 2022, 80 patients with coronary heart disease combined with T2DM treated in the Shangrao People’s Hospital were recruited. According to the insulin resistance index in a homeostasis model (HOMA-IR), patients were divided into group A (HOMA-IR>2.69, $n$ =42), and group B (HOMA-IR≤2.69, $n$ =38).The length and arc of calcified vessels, number of coronary artery lesions, length of stent covering coronary arterylesions and Gensini score between the two groups were compared. The correlation between HOMA-IR and the above indicators was identified. Results Compared with those of group B, significantly longer length of calcified vessels and stent covering coronary artery lesions, larger arc of calcified vessels and number of coronary artery lesions, and higher Gensini scores were detected in group A (all $P$ <0.05).Pearson correlation analysis showed that the length and arc of calcified vessels, number of coronary artery lesions, length of stent covering coronary arterylesions and Gensini scorewere positively correlated with HOMA-IR ( $r$ =0.75, 0.51, 0.43, 0.38, and 0.59, respectively, all $P$ <0.05). Conclusion There is a positive correlation between insulin resistance and coronary artery ischemia and calcification in patients with coronary heart disease combined with T2DM.

Key words: coronary disease, diabetes mellitus, type 2, coronary artery calcification, insulin resistance

CLC Number:

R541.4

Zhang Shangshi, Zhu Hongyan, Li Nan, Chen Yingxi. Correlation between coronary artery lesion and insulin resistance in patients with coronary heart disease combined with type 2 diabetes mellitus[J]. Clinical Focus, 2023, 38(1): 46-49.

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URL: https://huicui.hebmu.edu.cn/EN/10.3969/j.issn.1004-583X.2023.01.005

https://huicui.hebmu.edu.cn/EN/Y2023/V38/I1/46

Figures/Tables 4

Tab.1 Comparison of general data between groups

组别	例数	男性 [例(%)]	年龄 (岁)	吸烟史 (年)	饮酒史 (年)	糖尿病病程 (年)	BMI (kg/m²)	高血压 [例(%)]	抗血小板 [例(%)]	他汀类 [例(%)]
A组	42	30(71.4)	71.1±0.9	24.1±1.3	30.3±0.8	10.6±0.5	26.2±0.3	37(88.1)	29(69.0)	39(92.9)
B组	38	27(71.1)	69.6±0.7	23.6±1.1	32±1.4	9.8±0.4	25.6±0.1	33(86.8)	28(73.7)	35(92.1)
$t$ /χ²值		2.80	0.00	0.04	0.06	1.30	0.43	0.12	1.15	2.47
$P$ 值		0.18	1.26	0.35	2.16	0.34	0.06	0.09	6.23	3.91

Tab.1 Comparison of general data between groups

组别	例数	男性 [例(%)]	年龄 (岁)	吸烟史 (年)	饮酒史 (年)	糖尿病病程 (年)	BMI (kg/m²)	高血压 [例(%)]	抗血小板 [例(%)]	他汀类 [例(%)]
A组	42	30(71.4)	71.1±0.9	24.1±1.3	30.3±0.8	10.6±0.5	26.2±0.3	37(88.1)	29(69.0)	39(92.9)
B组	38	27(71.1)	69.6±0.7	23.6±1.1	32±1.4	9.8±0.4	25.6±0.1	33(86.8)	28(73.7)	35(92.1)
$t$ /χ²值		2.80	0.00	0.04	0.06	1.30	0.43	0.12	1.15	2.47
$P$ 值		0.18	1.26	0.35	2.16	0.34	0.06	0.09	6.23	3.91

Tab. 2 Comparison of laboratory data between groups

组别	例数	FINS (mU/L)	FBG (mmol/L)	2 hPBG (mmol/L)	HbA₁c (mmol/L)	LDL-C (mmol/L)	HDL-C (mmol/L)	TG (mmol/L)	TC (mmol/L)	尿酸 (mmol/L)	eGFR[ml/ (min·1.73 m²)]
A组	42	5.6±0.2	7.8±0.3	12.2±0.4	7.8±0.2	2.4±0.04	1.3±0.01	3.1±0.03	4.3±0.06	392.5±3.1	61.4±1.4
B组	38	4.5±0.1	7.3±0.2	12.1±0.1	7.5±0.1	2.3±0.03	1.3±0.02	3.2±0.04	4.1±0.05	387±2.8	63.5±1.7
$t$ /χ²值		1.31	0.52	0.34	2.29	0.02	1.46	0.07	0.18	1.13	2.17
$P$ 值		0.00	0.00	2.17	1.24	2.24	4.31	0.78	0.19	3.61	0.83

Tab. 2 Comparison of laboratory data between groups

组别	例数	FINS (mU/L)	FBG (mmol/L)	2 hPBG (mmol/L)	HbA₁c (mmol/L)	LDL-C (mmol/L)	HDL-C (mmol/L)	TG (mmol/L)	TC (mmol/L)	尿酸 (mmol/L)	eGFR[ml/ (min·1.73 m²)]
A组	42	5.6±0.2	7.8±0.3	12.2±0.4	7.8±0.2	2.4±0.04	1.3±0.01	3.1±0.03	4.3±0.06	392.5±3.1	61.4±1.4
B组	38	4.5±0.1	7.3±0.2	12.1±0.1	7.5±0.1	2.3±0.03	1.3±0.02	3.2±0.04	4.1±0.05	387±2.8	63.5±1.7
$t$ /χ²值		1.31	0.52	0.34	2.29	0.02	1.46	0.07	0.18	1.13	2.17
$P$ 值		0.00	0.00	2.17	1.24	2.24	4.31	0.78	0.19	3.61	0.83

Tab. 3 Comparison of coronary artery ischemia and calcification between groups

组别	例数	植入支架患者 [例(%)]	靶血管钙化长度 (mm)	靶血管钙化弧度 (°)	冠脉病变数目 (支)	支架覆盖病变长度(mm)	Gensini积分 (分)
A组	42	22(52.4)	21±1.3	226±23.5	2.1±0.5	47±2.1	32±5.6
B组	38	16(42.1)	17±0.8	153±17.4	1.6±0.5	31±1.6	27.2±4.9
$t$ /χ²值		0.74	0.58	6.23	2.61	0.32	3.42
$P$ 值		0.01	0.01	0.00	0.00	0.02	0.00

Tab. 3 Comparison of coronary artery ischemia and calcification between groups

组别	例数	植入支架患者 [例(%)]	靶血管钙化长度 (mm)	靶血管钙化弧度 (°)	冠脉病变数目 (支)	支架覆盖病变长度(mm)	Gensini积分 (分)
A组	42	22(52.4)	21±1.3	226±23.5	2.1±0.5	47±2.1	32±5.6
B组	38	16(42.1)	17±0.8	153±17.4	1.6±0.5	31±1.6	27.2±4.9
$t$ /χ²值		0.74	0.58	6.23	2.61	0.32	3.42
$P$ 值		0.01	0.01	0.00	0.00	0.02	0.00

Tab. 4 Correlation between coronary artery disease and HOMA-IR level

项目	$r$ 值	$P$ 值
靶血管钙化长度	0.75	0.00
靶血管钙化弧度	0.51	0.00
冠脉病变数目	0.43	0.01
支架覆盖病变长度	0.38	0.01
Gensini积分	0.59	0.00

Tab. 4 Correlation between coronary artery disease and HOMA-IR level

项目	$r$ 值	$P$ 值
靶血管钙化长度	0.75	0.00
靶血管钙化弧度	0.51	0.00
冠脉病变数目	0.43	0.01
支架覆盖病变长度	0.38	0.01
Gensini积分	0.59	0.00

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