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Remnant cholesterol for the detection of glucose metabolic states in patients with coronary heart disease angina pectoris

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Abstract

Background

This study aimed to evaluate the relationship between remnant cholesterol (RC) and glucose metabolic states in coronary heart disease (CHD) patients with angina pectoris.

Methods

This study collected data from 11,557 CHD patients with angina pectoris aged 35–75 years in Tianjin, China. Participants were divided into normal glucose regulation (NGR), prediabetes (Pre-DM) and diabetes mellitus (DM) groups according to glucose metabolic states. Linear regression analysis was used to explore the relationship between glucose metabolism [fasting blood glucose (FBG) and glycated hemoglobin (HbA1c)] and RC levels. Logistic regression was performed to analyze the relationship between RC levels and glucose metabolic states.

Results

Among all participants, 5883 (50.9%) had a DM state and 4034 (34.9%) had a Pre-DM state. FBG levels and HbA1c levels were positively related with RC in all patients (P < 0.001). NGR was used as a reference, multi-adjusted model showing that RC level was significantly associated with Pre-DM [Odds ratio (OR): 1.37; 95% confidence interval (CI) 1.19–1.56; P < 0.001] and DM state (OR:1.47; 95% CI 1.29–1.67; P < 0.001). When considering RC as categorical variables (tertiles), using T1 as a reference, T3 had the strongest relationship between RC levels and Pre-DM and DM state in univariate model and multivariate model. In the stratified analyses, the association between RC levels and pre-DM and DM in women was higher than that in men, and the elderly patients was higher than in the middle-aged patients.

Conclusion

The study demonstrated a significant association between RC levels and pre-DM and DM state among CHD patients with angina pectoris, and the relationship was stronger in women and elderly patients.

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Data availability

The datasets and analyzed used in the present study are available from the corresponding author on reasonable request.

Abbreviations

CHD:

Coronary heart disease

CAD:

Coronary artery disease

DM:

Diabetes mellitus

Pre-DM:

Prediabetes

TG:

Triglycerides

TC:

Total cholesterol

HDL-C:

High-density lipoprotein cholesterol

LDL-C:

Low-density lipoprotein cholesterol

VLDL:

Very-low-density Lipoproteins

IR:

Insulin resistance

HOMA-IR:

Homeostasis model assessment of insulin resistance

FBG:

Fasting blood glucose

HbA1c:

Glycated hemoglobin

SBP:

Systolic blood pressure

DBP:

Diastolic blood pressure

NGR:

Normal glucose regulation

OR:

Odds ratio

95% CI:

95% Confidence intervals

SEM:

Standard error of estimate

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Acknowledgements

We thank all the participants in the study and the members of the survey teams for their important contributions.

Funding

This work was supported by the National Basic Research Program of China (973 project, grant numbers: 2014CB542902).

Author information

Authors and Affiliations

  1. Tianjin University of Traditional Chinese Medicine, Tianjin, 301617, China

    Yang Wang, Yijia Liu, Rongrong Yang, Zhu Li, Jinyu Su, Tong Yang, Mei Ma, Guangwei Pan, Lin Li & Chunquan Yu

  2. First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, 300381, China

    Xianliang Wang

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  1. Yang Wang
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  3. Rongrong Yang
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  4. Zhu Li
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Contributions

CY, LL, XW were responsible for the study concept and design; YW, YL and RY analyzed the data together and drafted the manuscript; ZL, JS, TY, MM and GP contributed to data collection; All authors read and approved the final manuscript.

Corresponding authors

Correspondence to Xianliang Wang, Lin Li or Chunquan Yu.

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Conflict of interest

The authors declare that they have no competing interests.

Ethics approval and consent to participate

The study has passed the ethical review by the ethics committee of Tianjin university of Traditional Chinese Medicine. The ethical review approval number is TJUTCM-EC20190008. It was registered in the Chinese Clinical Trial Registry on July 14, 2019 (registration number: ChiCTR1900024535) and in Clinical Trials.gov on July 18, 2019 (registration number: NCT04026724). All participants waived informed consent.

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Yang Wang, Yijia Liu and Rongrong Yang should be considered joint first author.

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Wang, Y., Liu, Y., Yang, R. et al. Remnant cholesterol for the detection of glucose metabolic states in patients with coronary heart disease angina pectoris. Acta Diabetol 59, 1339–1347 (2022). https://doi.org/10.1007/s00592-022-01935-7

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