| Background and ObjectiveCardiovascular disease is the first fatal disease in the world. So,it is gotten more and more attention in the clinical research. The research of Coronary heart disease (CHD)which is the multi-etiological factors disease is also become hot. In the past years research shows that remedy-given hyperinsulinemia is the importance etiological factor of CHD.Remedy-given hyperinsulinemia happens when large-dose exogenous insulin infusion in order to abtain normal fasting blood glucose concentration. The CHD patients with type-2 diabetes mellitus accompanied by obesity and large dose administration are more likely to have coronary atherosclerosis. With the further study of the pathogenesis, more and more researcher pay close attention to the non-therapeutical effect of high-concentration insulin in vascular injury.The purpose of the study is to explore the effects of remedy-given insulin with a different dosage on aged type-2 diabetes mellitus . to evaluate the possible difference between the coronary angiography and 64-MSCT,to check the CHD risk factors on aged type-2 diabetes mellitus.Methods1 . There are 72 patients with CHD which received coronary angiography examination from September,2006 to September,2007. 42 aged CHD patients with type-2 diabetes mellitus who received insulin treatment were processed with insulin and peptic C measurement and angiography examination. And another 30 type-2 diabetes mellitus without insulin regimen were placed in control group.2.General information of patients were included as: age,sex,body weight,body mass,body mass index(BMI).3.Fasting serum insulin(FSI) were assayed by radioimmunoassay. 4.The severity of coronary artery atherosclerosis was quantified with a modified Gensini score on the basis of angiographic imaging.5.All data are analyzed with SPSS10.0 Quantitative variables were expressed as mean (±standard deviation) and categorical variables were expressed as (percentage). Two sample independent t tests were used to compare age and heart rate between the two groups. To compare categorical variables, Chi-square or Fisher exact tests were used where appropriate. P values < 0.05 were considered to identify statistically differences. P values < 0.01 were considered to identify statistically significant differences.All the analyses were performed using a commercially available statistical software (SPSS 12.0 for Windows, SPSS Incorporation, Chicago, IL, USA).Results1.FSI in experiment group was significantly higher than those in control group(P=0.022). Most patients in experiment group consumed insulin more than 30 IU each day.CP in experiment group was significantly lower than those in control group(P=0.007).2. FSI in experiment group was show a positive correlation with coronary lesion score or Gensini score(bj=0.547,P=0.015). peptide C related significant negatively with the Gensini score of coronary stenosis (bj=-0.38,P=0.017). The number of coronary artery lesions was show a positive correlation with FSI(bj=0.663,P=0.008).3. The Sensitivity, specificity, and positive and negative predictive values for Coronary artery lesions by MSCT were as follows: 83%, 98%, 87%, and 98%, respectively.ConclusionThe severity of coronary lesions was positively correlated with insulin and negatively correlated with peptide C. Remedy-given hyperinsulinimia is only independently correlated with coronary events in those type-2 diabetes mellitus. There might be certain association in the acute pathophysiology process of coronary lesion events. 64MSCT has high accuracy in detecting coronary artery stenosis of the aged patients with type-2 diabetes mellitus.
|
PDF Full Text Request