title: The comparison of coronary angiographic profiles between diabetic and nondiabetic patients with coronary artery disease in a Chinese population.
abstract: BACKGROUND
  It is well known that diabetes mellitus (DM) is a crucial risk factor for coronary artery disease (CAD). The present study aimed to investigate angiographic profiles of the coronary arteries in diabetic CAD patients in comparison with nondiabetics.
  
  
  METHODS
  A total of 546 Chinese patients were angiographically documented for CAD, 375 of whom were diabetics and 171 were nondiabetics according to the WHO diabetes criteria (1999). The patients in these two groups were matched for age, sex, and body mass index (BMI). The 75 g oral glucose tolerance test (OGTT) was performed in all patients, for whom blood glucose, insulin, glycosylated hemoglobin (HbA1c), triglyceride (TG), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), apolipoprotein A (ApoA), apolipoprotein B (ApoB), and lipoprotein(a) [Lp(a)] were measured. Insulin resistance (Homa-IR) and insulin secretion index (Homa-IS) were determined by the HOMA model. The clinical features and the data from selective coronary angiographies were compared between the diabetic and nondiabetic CAD patients.
  
  
  RESULTS
  Diabetic CAD patients had significantly higher waist to hip ratio (WHR) (p=0.016), fasting plasma glucose (FPG), 2h plasma glucose (2hPG), glycosylated hemoglobin (HbA1c) (p<0.001), insulin resistance index (Homa-IR) (p=0.001), and apolipoprotein A (ApoA) (p=0.008), with a significantly lower insulin secretion index (Homa-IS) level (p<0.001). Diabetic patients had one-vessel disease less frequently (28.8% vs 46.2%, p<0.001), and three-vessel disease more frequently (35.2% vs 24.0%, p=0.009), and they also had significantly higher cumulative coronary atherosclerosis score (CAS) (p=0.003). The right coronary artery was significantly more frequently involved in diabetics (66.4% vs 52.6%, p=0.002), with a clearly higher CAS at the same time (p=0.002).
  
  
  CONCLUSIONS
  Diabetics were presented with more severe and diffuse angiographically documented coronary artery disease compared to nondiabetics. The right coronary artery was significantly more frequently involved in the diabetics. Duration of CAD, Homa-IR, and diabetes mellitus were the independent risk factors for CAD found in the present study, while ApoA was the protective one.
authors.affiliation: Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University, Shanghai, PR China.
authors.forename: Ming-Hui
authors.initials: MH
authors.lastname: Gui
authors.forename: Guang-Yi
authors.initials: GY
authors.lastname: Qin
authors.forename: Guang
authors.initials: G
authors.lastname: Ning
authors.forename: Jie
authors.initials: J
authors.lastname: Hong
authors.forename: Xiao-Ying
authors.initials: XY
authors.lastname: Li
authors.forename: An-Kang
authors.initials: AK
authors.lastname: Lü
authors.forename: Wei-Feng
authors.initials: WF
authors.lastname: Shen
authors.forename: Xin
authors.initials: X
authors.lastname: Gao
mesh_terms: D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D002681:China; D017023:Coronary Angiography / Q000379:methods*; D003327:Coronary Disease / Q000000981:diagnostic imaging*; D003925:Diabetic Angiopathies / Q000097:blood / Q000000981:diagnostic imaging*; D005260:Female; D005951:Glucose Tolerance Test; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007328:Insulin / Q000097:blood / Q000378:metabolism; D007333:Insulin Resistance; D000078790:Insulin Secretion; D008297:Male; D008875:Middle Aged; D049629:Waist-Hip Ratio
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007328:Insulin