title: Association of increased serum glycated albumin levels with low coronary collateralization in type 2 diabetic patients with stable angina and chronic total occlusion.
abstract: BACKGROUND
  We investigated whether serum glycated albumin (GA) levels are related to coronary collateralization in type 2 diabetic patients with chronic total occlusion.
  
  
  METHODS
  Blood levels of GA and glycosylated hemoglobin (HbA1c) were determined in 317 diabetic and 117 non-diabetic patients with stable angina and angiographic total occlusion of at least one major coronary artery. The degree of collaterals supplying the distal aspect of a total occlusion from the contra-lateral vessel was graded as low (Rentrop score of 0 or 1) or high collateralization (Rentrop score of 2 or 3).
  
  
  RESULTS
  For diabetic patients, GA (21.2 ± 6.5% vs. 18.7 ± 5.6%, P < 0.001) but not HbA1c levels (7.0 ± 1.1% vs. 6.8 ± 1.3%, P = 0.27) was significantly elevated in low collateralization than in high collateralization group, and correlated inversely with Rentrop score (Spearmen's r = -0.28, P < 0.001; Spearmen's r = -0.10, P = 0.09, respectively). There was a trend towards a larger area under the curve of GA compared with that of HbA1c for detecting the presence of low collateralization (0.64 vs. 0.58, P = 0.15). In non-diabetic patients, both GA and HbA1c levels did not significantly differ regardless the status of coronary collateralization. In multivariable analysis, female gender, age > 65 years, smoke, non-hypertension, duration of diabetes > 10 years, metabolic syndrome, eGFR < 90 ml/min/1.73 m2, and GA > 18.3% were independently determinants for low collateralization in diabetic patients.
  
  
  CONCLUSIONS
  Increased GA levels in serum are associated with impaired collateral growth in type 2 diabetic patients with stable angina and chronic total occlusion.
authors.affiliation: Department of Cardiology, Shanghai Rui Jin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, People's Republic of China. rjshenweifeng@gmail.com.
authors.forename: Ying
authors.initials: Y
authors.lastname: Shen
authors.forename: Lin
authors.initials: L
authors.lastname: Lu
authors.forename: Feng Hua
authors.initials: FH
authors.lastname: Ding
authors.forename: Zhen
authors.initials: Z
authors.lastname: Sun
authors.forename: Rui Yan
authors.initials: RY
authors.lastname: Zhang
authors.forename: Qi
authors.initials: Q
authors.lastname: Zhang
authors.forename: Zheng Kun
authors.initials: ZK
authors.lastname: Yang
authors.forename: Jian
authors.initials: J
authors.lastname: Hu
authors.forename: Qiu Jing
authors.initials: QJ
authors.lastname: Chen
authors.forename: Wei Feng
authors.initials: WF
authors.lastname: Shen
mesh_terms: D000368:Aged; D060050:Angina, Stable / Q000097:blood / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D019540:Area Under Curve; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D002908:Chronic Disease; D003097:Collateral Circulation; D017023:Coronary Angiography; D003326:Coronary Circulation; D054059:Coronary Occlusion / Q000097:blood / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology; D003925:Diabetic Angiopathies / Q000097:blood / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D017127:Glycation End Products, Advanced; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011237:Predictive Value of Tests; D012372:ROC Curve; D012307:Risk Factors; D012709:Serum Albumin / Q000032:analysis*; D015854:Up-Regulation; D000093423:Glycated Serum Albumin
chemical_list: D015415:Biomarkers; D006442:Glycated Hemoglobin; D017127:Glycation End Products, Advanced; D012709:Serum Albumin; D000093423:Glycated Serum Albumin; C517652:hemoglobin A1c protein, human