无糖尿病病史的急性冠脉综合征患者新诊断糖代谢异常的研究

目的了解中国急性冠脉综合征患者新诊断糖代谢异常的状况,探讨糖代谢异常与传统心血管危险因素的相关性.方法中国7城市52中心连续入选2005年6月1日至2005年8月31日间因急性冠脉综合征入住心脏监护病房,既往无糖尿病病史且入院血糖＜11.1 mmol/L的1328例患者.通过统一调查表收集患者资料;并在出院前进行简化口服葡萄糖耐量试验（OGTT）,了解患者糖代谢情况.结果在本研究入组人群（n=1328）中,高血糖人群（包括新诊断糖尿病和糖调节异常）的比例约为67%,符合糖尿病诊断的共287例,占全部入选病例的22%,糖调节异常为45%（601例）.不同糖代谢状态在血脂紊乱、高血压、体重指数、腰围、糖化血红蛋白之间的差异有统计学意义（P＜0.001）.多元Logistic回归分析显示腰围水平和血脂紊乱是新诊断糖尿病组的相对危险因素（P＜0.05）.结论无糖尿病病史的急性冠脉综合征患者新诊断糖代谢异常非常常见,新诊断的糖代谢异常与腰围水平和血脂紊乱密切相关.

Newly diagnosed abnormal glucose tolerance in patients with acute coronary syndrome and without known diabetes mellitus

Objective To investigate the prevalence of newly diagnosed abnormal glucose tolerance in patients with acute coronary syndrome and without known diabetes mellitus (DM) and to access the correlation of glucometabolic abnormality with traditional risk factors of cardiovascular diseases. Methods The clinical data of 1328 patients with cute coronary syndrome (ACS), without previous DM, and with the admission blood glucose <11.1 mmol/ who were consecutively admitted in 52 hospitals of 7 cities in China from June 1 to August 31 2005, were collected. A simple oral glucose tolerance test (OGTT) was conducted before they were discharged. Results Glucometabolic perturbation was seen in 887 of the 1328 patients (67%). The prevalence rates of newly diagnosed DM and impaired glucose regulation (IGR) were 22% and 45% respectively. Blood pressure, blood lipid, body mass index, waistline, and hemoglobin A1C were all significantly higher in those with glucometabolic perturbation than in those with normal glucose metabolism (all P<0.05). Waistline and blood lipid were the risk factors of abnormal glucometabolic status (both P<0.05).Conclusion Newly diagnosed DM is common among the ACS patients without DM history. Newly diagnosed glucometabolic status is associated with waistline and blood lipid.