Correlation Between Serum Lipid Ratio And Severity Of Coronary Artery Lesions In Elderly Patients With Type 2 Diabetes Complicated With Coronary Heart Disease

Background:Diabetes mellitus(DM)is a disease of progressive glucose,protein,fat,water and electrolyte metabolism disorders caused by insulin secretion and/or deficiency due to a variety of factors.It is mainly characterized by Hyperglycemia and can lead to multiple damage.Cardiovascular disease(CVD)is the main cause of death and disability in diabetic patients.Clearly and effectively controlling the risk factors of increased cardiovascular disease risk in diabetic patients is of great significance to reduce the hospitalization rate and mortality of patients.Objective:This subject collects the serum lipid index and coronary angiography results of elderly patients with type 2 diabetes and coronary heart disease,and analyzes the relationship between the serum lipid index and the severity of coronary artery.As non-traditional lipid parameters,serum lipid ratios have received much attention in recent years.This article aims to explore the correlation between serum lipid ratios and the severity of coronary heart disease in elderly patients with type 2 diabetes.Methods:A total of 204 elderly patients with type 2 diabetes who were admitted to the First Hospital of Shanxi Medical University and diagnosed with coronary artery disease from June 2016 to December 2017 were selected,and their medical history,general clinical data and coronary angiography results were collected.BMI,TG / HDL-C,TC / HDL-C,LDL-C/ HDL-C,TG / apo A1,LDL-C / apo A1,non-HDL-C / apo A1,apo B / apo A1 ratios were calculated.According to the results of coronary angiography,the severity of coronary lesions was evaluated using the Gennisi(GS)score standard.The total score was <20divided into low group,20?medium group <50 points,and high group ?50 points.The selected patients were divided into low group,middle group and high group.The clinical characteristics,biochemical indicators and serum lipid ratios of the three groups were compared,and the correlation between the serum lipid ratios and the GS score was analyzed.Results:1.Comparison of general clinical data: A total of 204 patients were selected for this study,including 111 males and 93 females.The low,middle,and high groups were 72(35.29%),81(39.71%),and 51(25.00%).With the increase of the severity of coronary artery disease,the proportion of elderly male patients increased(c2 =7.016,P =0.03),GS score increased(F=227.237,P=0.000),and the difference was statistically significant.There were no significant differences in age,smoking history,drinking history,hypertension history,body mass index and blood pressure among the groups.2.Comparison of Glycolipid metabolism index: As the level of TC(F =3.75,P=0.025),LDL-C(F =3.929,P =0.021),non-HDL-C(F =5.539,P =0.005),fasting blood-glucose(F =3.792,P =0.024),Hb A1c(F=12.941,P =0.000)gradually increased while apo A1(F =4.237,P =0.016)decreased,coronary artery disease aggravated.The difference were statistically significant.There were no significant differences in TG,HDL-C,apo B,and Lp(a)among patients in each group.3.Comparison of serum lipid ratios:As the level of TC/HDL-C(F=10.369,P =0.000)?LDL-C/HDL-C(F =8.984,P=0.000)?non-HDL-C/apo A1(F=14.618,P=0.000)?LDL-C/apo A1(F=11.363,P=0.000)?apo B/apo A1(F=9.147,P=0.000)gradually increased,coronary artery disease aggravated.The difference were statistically significant.There were no significant differences in TG/HDL-C and TG/apo A1 among patients in each group.4.Correlation between each indicator and GS score:The GS score was negativel y correlated with apo A1(r =-0.161,P =0.022)level,positively correlated with TC(r=0.150,P=0.032),non-HDL-C(r=0.184,P=0.008),fasting blood-glucose(r=0.192,P=0.006),Hb A1c(r=0.290,P =0.000),TC/HDL-C(r=0.233,P=0.001),LDL-C/HDL-C(r =0.175,P=0.012),non-HDL-C/apo A1(r=0.273,P=0.000),LDL-C/apo A1(r=0.200,P=0.004),apo B/apo A1(r =0.223,P =0.001)ratio.Correlation between serum lipid ratios and GS score were better than the single serum lipid index.5.Logistic regression analysis of influencing factors in high-group patients:Hb A1c(OR=1.464,P=0.000)and non-HDL-C/apo A1(OR=1.832,P=0.001)were risk factors for high-group patients.6.The ROC curve of the high-group patients diagnosed by each serum lipid index: the area under the curve of the serum lipid ratios,such as TC/HDL-C?LDL-C/HDL-C?non-HDL-C/apo A1?LDL-C/apo A1?apo B/apo A1,were greater than the single serum lipid index.Conclusion:Our data indicate that the serum lipid ratios are superior to conventional lipid parameters as predictors for the severity of CHD in T2 DM patients.They should be given high attention in clinical work.