Coronary angiographic studies of impaired glucose regulation and coronary artery disease in Chinese nondiabetic subjects

To investigate the prevalence and the extent of coronary artery disease (CAD) in nondiabetic Chinese patients with different categories of impaired glucose regulation (IGR): isolated impaired fasting glucose (I-IFG); isolated impaired glucose tolerance (I-IGT); and combined IFG and IGT (CGI). A total of 556 nondiabetic subjects who had undergone coronary angiography were included in this study. Subjects were classified according to the 75-g oral glucose tolerance test result: normal glucose tolerance (NGT) (n = 278), I-IFG (n = 52), I-IGT (n = 128), CGI (n = 98). Significant CAD is defined as the presence of one or more coronary vessels with the lumeninal reduction in diameter to a parts per thousand yen50% in a given subject. The severity and extent of coronary atherosclerosis are defined by the Gensini score, the worst artery score, and the number of diseased vessels with significant coronary stenosis (number of diseased vessels). The prevalence of significant CAD in I-IFG and I-IGT groups were similar (67.3%, P = 0.207; 67.4%, P = 0.068, respectively) but both were higher comparing with NGT group (57.9%), however, it was considerably higher in CGI group (85.9%, P < 0.001). The Gensini score, worst artery score, and number of diseased vessels were similar in NGT, I-IFG, and I-IGT groups, but all significantly increased in CGI group after adjustment for other traditional factors (all P < 0.001). Logistic regression analyses reveal fasting glucose but not 2-h glucose as a significant determinant in Gensini score, worst artery score, and number of diseased vessels. The prevalence and the extent of CAD did not differ significantly among subjects with NGT, I-IFG, and I-IGT, but increased significantly in those with CGI. Fasting glucose was more strongly associated with angiographically characterized coronary artery stenosis than 2-h glucose.