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

Acta Diabetol. 2022 Oct;59(10):1339-1347. doi: 10.1007/s00592-022-01935-7. Epub 2022 Jul 23.

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.

Keywords: Angina pectoris; Coronary heart disease; Diabetes mellitus; Glucose metabolic states; Prediabetes; Remnant cholesterol.

MeSH terms

  • Aged
  • Angina Pectoris / complications
  • Angina Pectoris / epidemiology
  • Blood Glucose / metabolism
  • Cholesterol
  • Coronary Disease* / complications
  • Coronary Disease* / epidemiology
  • Female
  • Glucose
  • Glycated Hemoglobin / metabolism
  • Humans
  • Male
  • Middle Aged
  • Prediabetic State*
  • Risk Factors

Substances

  • Blood Glucose
  • Glycated Hemoglobin A
  • Cholesterol
  • Glucose