Study On Correlation Between Serum Homocysteine And Red Blood Cell Distribution Width With Coronary Heart Disease Combined With Type 2 Diabetes Mellitus

Objective:To determine the correlation between the serum homocysteine(Hcy)and red blood cell distribution width(RDW)with coronary heart disease combined with type 2 diabetes mellitus,we can investigate the diagnostic value of Hcy and RDW to coronary heart disease combined with type 2 diabetes mellitus.Methods:110 cases of coronary heart disease combined with type 2 diabetes mellitus which were diagnosed by interventional therapy were selected in Shanxi Medical University No.1 Hospital.According to the result of coronary angiography,the patients were divided into experimental group(the degree of stenosis?50%,diagnosed type 2 diabetes mellitus,n=87)and control group(the degree of stenosis<50%,diagnosed type 2 diabetes mellitus,n=23).The experimental group were divided into three group(group one: single vessel lesion,group two: double vessel lesion,group three: multiple vessel lesion).RBC count,WBC count,Hb,Hct,MCV,RDW,PLT,PDW,MPV,PCT,ALT,AST,TC,TG,HDL,LDL,Cr,BUN,UA,TBIL,GLU,HbA1 c and Hcy levels were detected in each group.Logistic regression analysis was applied to predict the independent risk factors of coronary heart disease combined with type 2 diabetes mellitus.The ROC curve was adopted to evaluate the diagnostic value of Hcy and RDW to coronary heart disease combined with type 2 diabetes mellitus and the multivariate.Results:Compared with the control group,Hcy and RDW levels in experimental group were increased significantly,the differences were statistically significant(P<0.05).The serum Hcy and RDW levels were not statistically difference among the single vessel lesion group,the double lesion group and the multi lesion group.Binary logistic regression analysis showed that Hcy?HbA1c and RDW entered to the regression model,the regression coefficients were 0.549?1.114?1.212 respectively.The area under curve(AUC)of ROC curves of Hcy and RDW were 0.866(95%CI:0.793~0.938)?0.742(95%CI:0.634~0.850).The optimal critical value of Hcy and RDW were 13.85?mol/L and 13.75%,the sensitivity and the specificity were 0.866(95%CI:0.793~0.938)?0.742(95%CI:0.634~0.850)respectively.The optimal critical values of Hcy and RDW were Hcy,their sensitivity and specificity were 72.4%?43.7% and 87.0%?91.3% respectively.Conclusion:Hcy and RDW may not associated with the severity of coronary artery lesions,high level of Hcy and RDW may be an independent risk factor of CHD.