| Objective:To compare glycosylated hemoglobin (HbAlc), interleukin-6(IL-6), C-reaction protein (CRP) and endothelin (ET-1) in patients of diabetes mellitus, coronary heart disease as well as the diabetes mellitus merges coronary heart disease, analyze the relationship between HbA1c level and IL-6, CRP, ET-1 and the Gensini coronary score, discusse the HbAlc level to vascular endothelia function and severity of coronary artery stenosis.Methods:We selected 320 examples in Tianjin Chest Hospital in May 2008 to November 2009 continuously, measured their fasting plasma glucose (FPG), postprandial 2 hours plasma glucose (P2hPG), HbAlc, IL-6, CRP and ET-1, all examples accepted coronary angiography (CAG), evaluating the severity of coronary stenosis by Gensini integral method. According to the glucose and the result of CAG, divided all the subjects into four groups:control group 70 patients, diabetes group (DM group) of 35 cases, coronary heart disease group (CHD group) of 145cases and diabetes merges coronary heart disease group (DM+CHD group) of 70 cases. Comparing the level of HbA1c, IL-6, CRP, ET-1 and the coronary score in groups, analyzing the correlationship of the above indexes. The blood samples were taked from the median cubital vein next morning in hospital (fasting 8 hours). HbA1c was measured by ion exchange chromatography, IL-6 and ET-1 by radioimmunoassay, and CRP by enzyme-linked immunosorbent assay. FPG was measured in the laboratory department; P2hPG was measured in the finger blood next breakfast after ordinary diet.Results:1. The comparison of HbAlc level:the HbA1c level changed from the control group (5.77±0.51%) to the CHD group (5.86±0.42%) to the DM group (7.00±0.69%) and to the DM+CHD (7.45±1.17%) group ascendly.The HbA1c level of CHD group higher than the control group, but the difference had no statistics significance. The DM group, DM+CHD group had significantly higher HbAlc than the control group and the CHD group (P<0.01). The HbAlc level of the DM+CHD group was also significantly higher than the DM group (P<0.01). 2. The comparison of IL-6 level:the concentration of IL-6 changed from the control group (0.25±0.12ng/ml) to the DM group (0.27±0.16ng/ml) to the CHD group (0.27±0.12ng/ml) to the DM+CHD group (0.31±0.15ng/ml) ascendly.The concentration of IL-6 in the DM+CHD group much higher than the control group or the CHD group (P<0.05), but there was no significant differences between the DM group, the control group and the CHD group in each other.3. The comparison of CRP level:there was a same trend of CRP concentration as IL-6, and the same differences among the groups. The control group (69.36±32.85μg/l)< the DM group (73.24±24.49μg/l)< the CHD group (77.77±32.00μg/l)< the DM+CHD group (88.76±31.10μg/l).4. The comparison of ET-1 level:The trend of ET-1 concentration was as same as HbA1c, the control group (46.22±23.33pg/ml)< the CHD group (56.36±27.16pg/ml)< the DM group (61.84±27.47pg/ml)< the DM+CHD group. There were all significantly differences among the groups each other except the DM group contrast with the CHD group.5. The level of HbA1c showed a positive correlation with IL-6, CRP, ET-1 and coronary score, the correlation coefficient was 0.241,0.171,0.381, and 0.204 respectively.6. Through binary logistic regression analysis, HbAlc was closely related with coronary score.Conclusions:1. The level of HbA1c in CHD group higher than the control group, and HbA1c may reflect the recent average glucose level, so we should determine FPG and P2hPG of patients with coronary heart disease.2. The level of HbAlc in DM+CHD group much higher than the DM group, which may prompte diabetes with coronary heart disease had poor glycemic control. For diabetic patients, especially associated with coronary heart disease patients, HbAlc should be regularly detected in order to understand the recent glycemic control and adjust the treatment.3. The diabetes or the coronary heart disease had endothelial dysfunction, as the two diseases were coexistencing, the situation of endothelial dysfunction were more severe.4. The level of HbA1c showed a positive correlation with IL-6, CRP and ET-1 which reflected the endothelial function, so HbA1c level could reflect the damage of endothelia function in some extent.5. HbA1c was an independent integral factor of coronary score, and was closely related to coronary stenosis. |
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