The relationship between glucose tolerance and coronary artery lesion in the patients with coronary heart disease

Objective To investigate the relationship between glucose tolerance change and the coronary artery lesion in the patients with coronary heart disease. Methods One hundred and ninety three patients with coronary artery disease were divided into 3 groups according to WHO(1985) and American Diabetes Association (1997) standard of diabetic diagnoses: (1) normal glucose tolerance (NGT) group 122 cases; (2) impaired glucose tolerance (IGT) group 39 cases; (3) type 2 diabetes mellitus (DM) group 32 cases. All patients were examined by the coronary angiographic semiquantitative (CAG) and 75 g oral glucose tolerance test. Blood glucose, insulin, triglyceride (TG), total cholesterol (TC) and high density lipoprotein cholesterol (HDL C) were determined. The coronary artery changes were analysed by CAG, and the severity of coronary artery stenosis was evaluated according to American Heart Association standard. The risk factors of coronary artery lesion were analysed by pluralism stepwiss regression analysis. Results The coronary multivessel changes and the severity of coronary artery stenosis and calcification were more frequent in IGT group than those in NGT group (66.5% vs 35.1%, 8.9±3.6 vs 6.5±3.9, 6.3±3.6 vs 3.9±4.1 respectively, P0.05). Distal coronary change was more frequent in IGT group than that in NGT group. There was no significant difference of the above changes between IGT group and DM group. Blood TG, TC, insulin and blood pressure were positively and HDL C was negatively correlated with the coronary artery lesion. Conclusion There are similar morbidity and severity of coronary artery lesion in IGT and DM groups. The coronary multivessel lesion and distal coronary and diffusing stenosis are more frequent in IGT or DM group than those in NGT group. Dyslipidemia, hyperinsulinemia and hypertension are independent risk factors for coronary artery disease.