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).
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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.
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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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DOI: https://doi.org/10.1007/s00592-022-01935-7