| Objectives To investigate the relationship between postprandial blood lipid metabolism and coronary artery lesion severity in patients with coronary heart disease complicated with type 2diabetes mellitus.Methods 127 cases were selected who were diagnosed as coronary heart disease by quantitative coronary angiographyfrom January 2015 to December 2015. And all the patients met the diagnostic criteria of type 2 diabetes. There were 77 male and 50 female patients, the average age(60.6± 6.1)years. According to the different levels of TG before and after the meal, the patients were divided into three groups: Postprandial triglyceride normal group was group A(Fasting TG < 1.7mmol/L and postprandial 4h TG > 2.0mmol/L), A total of 23 cases, including 17 males, 6 female mean age(64.22 ± 6.57) years old; Postprandial high triglyceride group was group B(Fasting TG < 1.7mmol/L and postprandial 4h TG > 2.0mmol/L), A total of 37 cases,including 23 males, 14 female mean age(61.41±8.50) years old; Fasting high triglyceride group was group C(fasting TG>1.7mmol/L)A total of 67 cases, including 37 males, 30 female mean age(58.9±9.77) years old. All selected patients’ venous blood was taken in fasting, 2 hours after the meal, 4 hours after the meal, In order to detect fasting blood glucose, blood lipid, postprandial2 hours blood glucose. To record all in detail about the smoking history, drinking history, patients with allergic history, history of hypertension, history of diabetes, height, weight, blood pressure,and body mass index. The results of coronary angiography were analyzed, and the calculation of Gensini integral was calculated. All the data were analyzed statistically by application SPSS17.0.Application of correlation analysis to evaluate the correlation between Gensini score and clinical indexes. Independent risk factors of coronary heart disease complicated with type 2 diabetes mellitus by stepwise regression analysis.Results 1 Total cholesterol, glycosylated hemoglobin, fasting blood glucose, postprandial 2hours blood glucose, fasting and postprandial triglyceride, group A and group B patients had no significant difference(P>0.05), The patients in group C had significant statistical difference compared with the previous two groups(P<0.05). 2 The 3 groups of patients after meal 4 hours of triglyceride were increased, and there was statistical significance(P<0.05). 3 Correlation risk factors of coronary heart disease and Gensini score were analyzed by correlation. Results show:Postprandial 4 hours of triglycerides, diabetes duration, postprandial 2 hours blood glucose,glycosylated hemoglobin, fasting blood glucose, total cholesterol, fasting triglycerides, low density lipoprotein cholesterol and Gensini scores were significant of positive correlation, the correlation coefficient r was 0.674、0.615、0.568、0.530 、0.215、0.433、0.372、0.176.respectively. The other factors were not statistically related. 4 The Gensini score which is an index to evaluate the degree of coronary artery diseasewas used as the dependent variable. The relevant risk factors of coronary heart disease were included in the stepwise regression equation.The results showed that postprandial triglyceride 4 hours, 2-hour postprandial blood glucose, duration of diabetes, fasting total cholesterol, low density lipoprotein levels and, smoking index may be the important risk factors for coronary artery disease complicated with type 2 diabetes mellitus in patients with coronary heart lesion.Conclusions 1 Postprandial triglyceride levels in patients with coronary heart disease complicated with type 2 diabetes mellitus can be significantly increased, total cholesterol, highdensity lipoprotein cholesterol, low density lipoprotein cholesterol has no significant change. 2 In addition to smoking index, duration of diabetes, 2 hour postprandial blood glucose, fasting total cholesterol, low density lipoprotein, postprandial triglyceride levels may be the important risk factors for coronary artery disease complicated with type 2 diabetes mellitus in patients with coronary heart lesion. |
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