Prevalence, predictors, and consequences of unrecognized diabetes mellitus in 3266 patients scheduled for coronary angiography

Taubert, G.; Winkelmann, Bernhard R.; Schleiffer, T; März, Winfried; Winkler, Ralph; Gök, Rahime; Klein, Bärbel; Schneider, Steffen; Boehm, Bernhard O.

doi:10.1067/mhj.2003.134

Cited by 92 publications

(68 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…1-6 Taubert's study in Germany showed that 46.6% of DM patients were not diagnosed previously in high-risk CAD patients scheduled for coronary angiography. 1 A recent Chinese heart survey by Hu et al 4 showed that undiagnosed T2DM accounted for nearly 40% of all T2DM patients in hospitalized CAD patients. In our study, the rate of newly diagnosed T2DM during hospitalization was 37.0%, which is consistent with Hu's study.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies also showed that coronary artery lesions and prognosis were worse in CAD patients with newly diagnosed DM than in nondiabetic patients, and were even worse compared with known DM patients because the risk factors had been poorly controlled on the basis of delayed diagnosis. [1][2][3]11,12,31 Obviously, both known DM patients and previously unrecognized DM patients should be considered to be equally important. In this study, the previously known and unknown DM patients were both included in the DM group.…”

Section: Discussionmentioning

confidence: 99%

“…[10][11][12] Therefore, more and more research efforts have focused on the prevalence, characteristics, predictors, etiologies, economic burdens and therapy strategies of CAD patients with T2DM. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17] Recently, studies showed that countries in East Asia had similar and even higher prevalence of T2DM in CAD patients compared with Western countries, although East Asians usually had a lower body mass index (BMI) and less hyperlipidemia. Mechanisms for this population-specific difference are not known.…”

Section: Introductionmentioning

confidence: 99%

“…It is reported that 35-55% of CAD patients have the complication of T2DM in Eastern and Western countries. [1][2][3][4][5][6] Studies also suggest that CAD patients with T2DM showed more serious and diffused coronary atherosclerotic lesions, with less collateral circulations, poor life quality and prognosis than did CAD patients without T2DM. [7][8][9] These patients also suffered more major adverse coronary events, even after revascularization therapies.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

ALDH2 genetic polymorphism and the risk of type II diabetes mellitus in CAD patients

Chen

et al. 2009

Hypertens Res

View full text Add to dashboard Cite

The prevalence of type II diabetes mellitus (T2DM) in coronary artery disease (CAD) patients has been steadily increasing, especially in East Asian countries. Although many studies have suggested that certain genetic variants may predispose to the development of T2DM, very few studies investigated the genetic link with T2DM in CAD patients of East Asia. In this study, we investigated the relationship between Glu504Lys polymorphism in the acetaldehyde dehydrogenase 2 (ALDH2) gene, a key enzyme of alcohol metabolism, and the risk of having T2DM in Chinese Han CAD patients. We enrolled 542 CAD patients (180 women and 362 men) and 309 CADÀ/DMÀ subjects (152 women and 157 men). T2DM was confirmed in 47.4% of CAD patients. Logistic and linear regression analyses showed that ALDH2 mutant genotypes (*1/*2 and *2/*2) were an independent risk factor for both T2DM in female CAD patients, even after controlling for alcohol consumption (OR¼1.95, P¼0.043), and fasting plasma glucose (FPG) in CADÀ/DMÀ women (P¼0.015), whereas the association with FPG disappeared after controlling for high-sensitivity C-reactive protein, a classic inflammatory biomarker. However, there was no relationship between the ALDH2 genetic polymorphism and T2DM or FPG in men. These findings suggest that the ALDH2 polymorphism is associated with an increased risk of T2DM in female CAD patients, and this association could be causal on the basis of the association between the polymorphism and FPG, which is partly explained by an increased inflammatory status. These findings will benefit the screening and treatment of a high-risk population in East Asians.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

ALDH2 genetic polymorphism and the risk of type II diabetes mellitus in CAD patients

Chen

et al. 2009

Hypertens Res

View full text Add to dashboard Cite

show abstract

“…Type 2 diabetes was defined according to the new criteria of the American Diabetes Association (ADA) and the provisional criteria of the World Health Organization (WHO) [31,32,33]. Unlike in a previous study of the same cohort [34], subjects with a single test showing a high blood glucose level, in the absence of a confirmatory test, were not assigned an unequivocal diabetes status. Older age was defined by the 50th percentile of the study population.…”

Section: Study Population and Clinical Definitionsmentioning

confidence: 99%

Association between the A?2518G polymorphism in the monocyte chemoattractant protein-1 gene and insulin resistance and Type 2 diabetes mellitus

et al. 2004

View full text Add to dashboard Cite

Aims/hypothesis. The molecular mechanisms of obesity-related insulin resistance are incompletely understood. Macrophages accumulate in adipose tissue of obese individuals. In obesity, monocyte chemoattractant protein-1 (MCP-1), a key chemokine in the process of macrophage accumulation, is overexpressed in adipose tissue. MCP-1 is an insulin-responsive gene that continues to respond to exogenous insulin in insulin-resistant adipocytes and mice. MCP-1 decreases insulin-stimulated glucose uptake into adipocytes. The A-2518G polymorphism in the distal regulatory region of MCP-1 may regulate gene expression. The aim of this study was to investigate the impact of this gene polymorphism on insulin resistance. Methods. We genotyped the Ludwigshafen Risk and Cardiovascular Health (LURIC) cohort (n=3307). Insulin resistance, estimated by homeostasis model assessment, and Type 2 diabetes were diagnosed in 803 and 635 patients respectively. Results. Univariate analysis revealed that plasma MCP-1 levels were significantly and positively correlated with WHR (p=0.011), insulin resistance (p=0.0097) and diabetes (p<0.0001). Presence of the MCP-1 G-2518 allele was associated with decreased plasma MCP-1 (p=0.017), a decreased prevalence of insulin resistance (odds ratio [OR]=0.82, 95% CI: 0.70-0.97, p=0.021) and a decreased prevalence of diabetes (OR=0.80, 95% CI: 0.67-0.96, p=0.014). In multivariate analysis, the G allele retained statistical significance as a negative predictor of insulin resistance (OR=0.78, p=0.0060) and diabetes (OR=0.80, p=0.018). Conclusions/interpretation. In a large cohort of Caucasians, the MCP-1 G-2518 gene variant was significantly and negatively correlated with plasma MCP-1 levels and the prevalence of insulin resistance and Type 2 diabetes. These results add to recent evidence supporting a role for MCP-1 in pathologies associated with hyperinsulinaemia.

show abstract

Outcomes of hospitalizations for myocardial infarctions and cerebrovascular accidents in patients with systemic lupus erythematosus

Ward¹

2004

Arthritis & Rheumatism

View full text Add to dashboard Cite

Objective. Patients with systemic lupus erythematosus (SLE) have increased risks of acute myocardial infarction (AMI) and cerebrovascular accident (CVA), but it is not known whether they have worse outcomes after AMI or CVA compared with patients without SLE. This study compared in-hospital mortality, length of stay, and other measures of severity (congestive heart failure or need for coronary artery bypass grafting after AMI; discharge to a skilled nursing facility after CVA) between patients with SLE and patients without SLE who were hospitalized for AMI or CVA.Methods. Data on all patients hospitalized in California with either AMI or CVA from 1996 to 2000 were abstracted from a state hospitalization database. Outcomes after AMI were compared between 519 patients with SLE and 214,771 patients without SLE, and outcomes after CVA were compared between 905 patients with SLE and 293,326 patients without SLE. Analyses were performed separately for men and women.Results. Among women with AMI, there were no differences in the risk of in-hospital mortality, long length of stay, or congestive heart failure between patients with SLE and those without SLE, but women with SLE were less likely to undergo coronary artery bypass grafting. Outcomes after AMI did not differ between men with SLE and men without SLE. Among women with CVA, there were no differences in outcomes between patients with SLE and patients without SLE. Men with SLE were almost twice as likely to have a long length of stay after CVA than were men without SLE.Conclusion. Outcomes after AMI and CVA are generally similar between patients with SLE and those without SLE.Patients with systemic lupus erythematosus (SLE) have an increased risk of cardiovascular and cerebrovascular events compared with persons without SLE. Risks for acute myocardial infarctions (AMI) have been estimated to be 2-52 times higher in patients with SLE, and risks for cerebrovascular accident (CVA) have been estimated to be 2-10 times higher in these individuals (1-4). Atherosclerotic events also tend to occur at younger ages in patients with SLE, and the relative risks for these events are higher among younger patients (2,3). However, it is not known whether AMI or CVA is more severe in patients with SLE. Most studies that have noted the severity of atherosclerotic events in patients with SLE have been small case series (5-11). In the only large study, mortality after AMI and CVA was similar among patients with end-stage lupus nephritis and patients with other causes of end-stage renal disease (12). Measures of severity other than mortality were not examined, and the study did not include patients without end-stage renal disease or men. Because patients with end-stage renal disease represent only a small and highly selected subset of patients with SLE, these findings may not apply to patients with SLE who do not have renal failure.In this study, the severity of AMI and the severity of CVA were compared between patients with SLE and those without SLE, in a large population-based sample...

show abstract

Prevalence, predictors, and consequences of unrecognized diabetes mellitus in 3266 patients scheduled for coronary angiography

Cited by 92 publications

References 26 publications

ALDH2 genetic polymorphism and the risk of type II diabetes mellitus in CAD patients

ALDH2 genetic polymorphism and the risk of type II diabetes mellitus in CAD patients

Association between the A?2518G polymorphism in the monocyte chemoattractant protein-1 gene and insulin resistance and Type 2 diabetes mellitus

Outcomes of hospitalizations for myocardial infarctions and cerebrovascular accidents in patients with systemic lupus erythematosus

Contact Info

Product

Resources

About