| BackgroundCoronary heart disease(CHD)refers to the heart disease which is caused by ischemia,hypoxia,and necrosis of the myocardial cells caused by atherosclerosis limiting the blood flow in the coronary arteries.It is one of the most serious diseases threatening human health in the world today.Ether in developed countries such as Europe and the United States,or in China,the number of patients with coronary heart disease is increasing due to factors such as an aging population,a prolonged life expectancy,and lifestyle changes.At present,epidemiological studies represented by the Framingham study in the United States indicate that the risk factors for coronary heart disease include diabetes,age,smoking,blood pressure,dyslipidemia,overweight and others.Blood lipids include total cholesterol(TC),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C)and triglyceride(TG).Epidemiological studies have shown that LDL-C is positively associated with cardiovascular disease and HDL-C is negatively associated with the risk of cardiovascular disease.Some clinical trials have concluded that there is a linear correlation between the level of TG and the risk of cardiovascular disease,but when aggregately analyzed with TC,HDL-C,and LDL,elevated TG levels do not increase the risk of coronary heart disease.At the same time,other studies have shown that the incidence of coronary heart disease is higher in diabetic patients and that diabetic patients are often accompanied by elevated triglyceride levels,while low-density cholesterol levels are not elevated or slightly elevated.The correlation between TG and coronary heart disease is still controversial.Recent studies have shown that triglyceride-glucose index(TG-G),triglyceride-glucose-BMI index(TG-G-BMI)is associated with the prognosis of type 2 diabetes and insulin resistance which can predict the extent of insulin resistance.They are reliable indicators for assessing the risk of complications and complications in diabetic patients.However,the correlation between the TG-G index,the TG-G-BMI index and the severity of coronary atherosclerotic lesions remains unclear.Diabetes is a risk equivalent of coronary heart disease,as a result,indicators such as TG-G index,TG-G-BMI index and others may be related to the degree of coronary atherosclerotic lesion.At present,coronary angiography is considered to be the gold standard for the diagnosis of coronary heart disease,and is of great significance for the early diagnosis and treatment of coronary heart disease.However,the coronary angiography requires a higher level of equipment and physician skills and is more expensive and more dangerous.Therefore,by studying the relationship between TG-G index,TG-G-BMI index and the degree of coronary atherosclerotic lesion,we can predict their value in clinical application and provide a new reference for the diagnosis of coronary heart disease.Objective1.Analyze the correlation between blood lipids,blood glucose levels and the severity of coronary heart disease and coronary atherosclerotic lesions.2.To analyze the correlation between serum markers TG-G index and TG-G-BMI index and the severity of coronary atherosclerotic lesion and to explore their value in predicting and evaluating coronary heart disease.Patients and methods1.Collecting patientsPatients who underwent coronary angiography at Qilu Hospital of Shandong University and met the inclusion criteria were enrolled.2.Data collection and analysisData of basic medical history,serum indicators,and coronary angiographic results were collected from selected patients.All serological indicators were determined by the clinical laboratory of Qilu Hospital of Shandong University.The non-normally distributed data is converted to a normal distribution by data,and then statistical analysis is performed.Nonparametric tests are used for data that cannot be distributed normally through conversion.A comparison of the data sets that met the normal distribution conditions was analyzed by ANOVA analysis of variance,and an independent sample t-test was used to compare the comparisons between the two groups.Relevant factors were analyzed by Spearman's analysis and multiple linear regression analysis.The linear correlation between the measured data was analyzed by multiple linear regression analysis.Result1.From September 1st,2015 to September 1st,2018,346 patients with non-acute percutaneous coronary angiography in Qilu Hospital of Shandong University were randomly selected,including 213 male patients(61.60%),133 female patients(38.40%).Among them 270 patients(78.03%)were diagnosed with coronary heart disease,and 76 patients(21.97%)were diagnosed with non-coronary heart disease.Of these patients,92(26.60%)were diagnosed with diabetes and 254(73.40%)were non-diabetic.2.Among patients with coronary heart disease,the proportion of patients with diabetes mellitus(30.37%)was higher than that of patients in non-coronary heart disease group(13.16%)(P<0.05).And the proportion of patients with smoking history among patients with coronary heart disease(51.11%)was also higher than that in the non-coronary heart disease group(35.53%)(P<0.05).The age of patients with coronary heart disease(61.36±9.43 years)was higher than that of non-coronary heart disease group(57.72±8.34 years)(P<0.05).3.Serum LDL-C levels in patients with coronary heart disease(2.75±0.75 mmol/L)were significantly higher than those in non-coronary heart disease group(2.40±0.83 mmol/L)(P<0.01).The level of LDL-C in diabetic patients with coronary heart disease group(2.64±0.611 mmol/L)was not different from that in diabetic patients without coronary heart disease group(2.00±0.62 mmol/L)or in the control group(P>0.05).The level of TG in the patients with both coronary heart disease and diabetes(1.78±0.90 mmol/L)was significantly higher than that in the control group(1.38±0.64 mmol/L)(P<0.01).4.The Leaman score(7.25/13.00)and Gensini score(55.50/50.00)were significantly higher in diabetic patients than in non-diabetic patients(4.5/10.50,35.50/41.13)(p<0.01).The Leaman score and Gensini score of patients with both coronary heart disease and diabetes mellitus showed no difference with patients with coronary heart disease but no diabetes(P>0.05).5.The TG-G index and TG-G-BMI index of the coronary heart disease group were significantly higher than those of the non-coronary heart disease group(P<0.01).The two indexes of patients with both coronary heart disease and diabetes mellitus and patients with coronary heart disease but no diabetes were higher than those in the control group(P<0.05).Both the TG-G index and the TG-G-BMI index were positively correlated with the degree of coronary artery stenosis and the degree of coronary artery stenosis can be predictedConclusionTG-G index,TG-G-BMI index in patients with coronary heart disease were significantly higher than those in patients with non-CHD.TG-G index,TG-G-BMI index in patients with both coronary heart disease and diabetes mellitus were higher than those in normal people.There is a positive correlation between TG-G index,TG-G-BMI index and the degree of coronary artery stenosis.TG-G index and TG-G-BMI can predict the degree of coronary artery stenosis. |
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