Correlation Between GGT And Coronary Artery Culprit Lesions In Patients Of Type 2 Diabetes With Coronary Artery Disease

ObjectiveTo investigate the correlation between the serum gamma glutamine transferase(GGT) and the severity of coronary artery lesions in patients of type 2 diabetes with coronary heart disease. We aimed to show the importance of GGT measurement in diagnosis of coronary artery disease(CAD).Methods:From March 2013 to March 2014 in the Department of Cardiovascular, the third affiliated Hospital of The Third Military School, 226 inpatients with type 2 diabetes who underwent coronary angiography were enrolled in this study(134 male, mean age: 65.27±9.87years). Type 2 diabetes is diagnosis according to Chinese Guidelines for the prevention and treatment of type 2 diabetes in 2013. All patients had no severe liver disease, severe kidney disease, severe lung disease, severe brain isease, thyroid dysfunction, other organic heart diseases, refractory hypertension, malignant arrhythmia, peripheral vasculardisease, anemia, cancer, gastrointestinal diseases, Radiography agent allergy history, digitalis toxicity. According as the results of selective coronary angiography, the patients were divided into coronary lesions group(which calculated the Gensini score) and coronary artery normal group. We collected dataes which contain the index such as age, sex, smoking, BMI, systolic blood preasure(SBP) and diastolic blood preasure(DBP), aspartate aminotransferase(AST), alanine aminotransferase(ALT), gamma glutamine transferase(GGT), Low density lipoprotein cholesterol(LDL-C), High density lipoprotein cholesterol(HDL-C), Total cholesterol(TC), Triglyceride(TG), Serum creatinine(Scr), Serum albumin(ALB), Glucose(Glu), Hemoglobin A1c(Hb A1c), C-peptide. Compare the clinical data of two groups of patients and analysis the correlation between the serum gamma glutamine transferase(GGT) and the severity of coronary artery lesions in patients of type 2 diabetes with coronary heart disease.Results:1. Indexes such as Ages, BMI, LDL-C, HDL-C, GGT, C-peptide and Gensini score in coronary lesion group were respectively statistical significant than normal group(P<0.05), while other factors such as gender, Glu, SBP, DBP, TC, TG, AST, ALT, Scr, ALB had no significant difference.2. According to the level of the Gensini score, CHD patients can be divided into three subgroups,which were the severe lesion group(Gensini score>40score), the mild lesion group(Gensini score 20-40score), the morderate lesion group(Gensini score <20); then make comparison of the three groups of the serum GGT, LDL, C-peptide. Both the mean value of GGT and the mean value of C-peptide in the severe lesion group is higher than the morderate lesion group(P < 0.05), and that in the severe lesion group is higher than the mild lesion group(P < 0.05), and that in the mild lesion and the morderate lesion group has no signifficantly difference(P>0.05); the mean value of LDL-C in the severe lesion group is signifficantly higher than the morderate lesion group(P<0.01), and that in the severe lesion group is signifficant higher than the mild lesion group(P<0.01), and that in the mild lesion is signifficant higher than the morderate lesion group(P<0.01).3. The least-significant difference rank correlation analysis presents that the serum GGT and LDL-C are positive correlated with the Gensini Score(r=0.373,P<0.01)�'�(r=0.264,P<0.01).4. In ROC curve analysis, the area under curve for GGT was 0.674(95%CI:598-0.750) for coronary lesion group, compared to the AUS of BMI(0.703, 95%CI:0.624~0.782)、LDL(0.687, 95%CI:0.608~0.765), and better than that of insulin C peptide(0.592, 95%CI:0.592) and HDL(0.379, 95%CI:0.298~0.461).Conclusion:The serum GGT levels in Patients with type 2 diabetes mellitus and coronary heart disease are positively associated with the degree of coronary artery lesions that can be used as a predictor of coronary risk independent evaluation index,especially in the backward medical condition of the district hospitals has its value and significance.