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Relationship between Diabetes Mellitus with Negative Coronary Angiography Results and Glycosylated Low Density Lipoprotein

Author: MaXiangBo
Tutor: LiQingXian
School: Shandong University
Course: Internal Medicine
Keywords: G-LDL Angiographically normal coronary arteries Diabetesmellitus Atherosclerotic
CLC: R541.4
Type: Master's thesis
Year: 2013
Downloads: 16
Quote: 0
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Abstract


Research background Diabetes is a major risk factor for atherosclerosis, diabetic patients with high blood sugar, a series of reactions and in vivo macromolecules, resulting in glycosylated low density lipoprotein (G-LDL) in the generation and deposition in vivo, occurrence and development of atherosclerosis plays a promoting role. In the past diabetes with no coronary heart disease as risk factor for coronary heart disease, at present has been upgraded to a CHD risk equivalent. At present, such as the risk of hypertension, hyperlipidemia, obesity and smoking factor of coronary heart disease, are not enough to explain why diabetic patients have such a high rate of incidence of atherosclerosis. But the clinical still found part of the diabetic patients, even had diabetes for5years, after coronary angiography has not yet found any plaque.Research objective the experimental determination of DM-NCHD group and DM-CHD group with nitro blue tetrazolium chloride method at the G-LDL level, to explore the relationship between coronary angiography negative and G-LDL. At the same time, the use of automatic biochemical analyzer (Sapphire600) determination of total cholesterol (CHOL), high density lipoprotein cholesterol (HDL) and low density lipoprotein cholesterol (LDL), triglyceride (TG). TG using glycerol phosphate oxidase method, HDL, LDL are the use of chemical modification of enzyme method. Glycosylated hemoglobin (HbA1C) were measured by the micro column chromatography. Study on the relationship between coronary angiography negative and the correlation between G-LDL and G-LDL, TG, HbAlc, LDL, HDL, CHOLResearch methods According to the diagnostic criteria for diabetes (1999WHO),49of all diabetic patients with angiographically normal coronary arteries from2011June to2012September in Department of Cardiology of Affiliated Hospital of Jining Medical College Department of Cardiology in hospital patients, through random sampling method to select50cases of patients with positive diabetic coronary angiography,50cases of normal control group. All subjects were aged between55-75years of age, history of diabetes mellitus diabetic patients were over5years, were excluded from the liver and kidney dysfunction, hormone replacement therapy, patients with hyperthyroidism, tumor, disturbances of blood coagulation and do not agree with the patients involved in the study, informed consent. All subjects were in the early morning fasting venous blood, using nitro blue tetrazolium chloride method. Determination of principle:using isolated serum G-LDL precipitation method, under alkaline conditions, compound G-LDL the NBT reduction generation purple, content depth and G-LDL whose color is proportional to the measured absorbance at530nm, spectrophotometer (A) values, calculated index of G-LDL=A x500, determination the results for the index, no unit. The use of automatic biochemical analyzer (Sapphire600) determination of triglycerides (TG), total cholesterol (CHOL), high density lipoprotein cholesterol (HDL) and low density lipoprotein cholesterol (LDL). TG using glycerol phosphate oxidase method, HDL, LDL are the use of chemical modification of enzyme method. Glycosylated hemoglobin (HbA1C) were measured by the micro column chromatography. Using SPSS13.0statistical analysis software, the measurement data with the mean±standard deviation (x±s), between the two groups using t test, single factor between the groups was compared using analysis of variance. Multiple factors were analyzed by multiple linear stepwise regression analysis, the inclusion criteria0.05, excluding the standard0.10. With P<0.05for the difference was statistically significant. The ROC curve using SPSS, the serum G-LDL level was tested with variable, using the result of coronary artery angiography as state variables, for the analysis of ROC curve, and find out the breakpoint.research results1.Group DM-NCHD G-LDL levels were lower in the DM-CHD group (P<0.05), higher than that of NC group (P<0.05). 2The G-LDL levels in the DM-CHD Group were positively correlated with the degree of coronary atherosclerosis.3Multiple linear stepwise regression analysis showed that:the G-LDL as the dependent variable, TG, LDL, HDL, CHOL, HbA1c to make a multiple linear regression analysis showed that G-LDL was positively correlated with the dependent variable, TG, has nothing to do with the HbA1c, LDL, HDL CHOL.4horizontal1-axis for the sensitivity, specificity, and area under ROC curve0.805, area of standard error is0.044, the level of serum G-LDL for diagnosis of coronary atherosclerosis was significant (P=0.000). Serum G-LDL was50.45, the sensitivity was0.80, specificity was0.84.Research result G-LDL levels in the DM-NCHD group was significantly lower than those in the DM-CHD group, and the G-LDL levels in the DM-CHD Group were positively correlated with the degree of coronary atherosclerosis, G-LDL is expected to be the effective indicator to evaluate the risk of coronary atherosclerotic in patients with diabetes mellitus.

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CLC: > Medicine, health > Internal Medicine > Heart, blood vessels ( circulatory ) disease > Heart disease > Coronary arteries ( atherosclerosis ),heart disease (CHD)
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