Abstract
In view of the fact that diabetes mellitus (DM) is a major risk factor in ischemic heart disease, we conducted a study on the relationship between DM and coronary arteriosclerosis. Previous reports have addressed patients with concurrent coronary artery disease (CAD), DM, hyperlipidemia, and significant coronary artery stenosis (>50%). There have also been reports correlating etiologic data with patient gender. However, to the best of our knowledge, there have not been any published reports that consider patients with CAD and DM exhibiting normolipidemia, data on patients with mild stenosis (>50%), or reports relating gender with CAG confirmed CAD data. Therefore, we conducted studies on 220 patients who had undergone coronary arteriography at our institution, and we analyzed the relationship between the severity of stenosis in CAD and the interaction of DM with hyperlipidemia and normolipidemia, how the influence of DM on CAD differed by gender, and the relationship between DM and mild coronary arteriosclerosis. The incidence of DM in CAD was high and proportionally increased with the severity of stenosis of the CAD. The male/female ratio in CAD was different for the DM and non-DM groups. In both normolipidemia and hyperlipidemia the severity of CAD was greater in the DM group than in the non-DM group. Females with DM and CAD exhibited a greater body mass index (BMI), Apo B, B/Al, than non-DM with CAD females; however, no differences were observed in the males. Both the DM and non-DM groups with mild coronary arteriosclerosis exhibited a much higher level of total cholesterol (TC), atherosclerosis index (AI), TC/HDL-C, LDL-C/HDL-C, LDL-C/Apo Al, and lower HDL-C than the DM and non-DM normal coronary groups. This finding indicates that the effect of DM is less pronounced in the early stages of coronary arteriosclerosis. Coupled with previous data where the effect of DM was seen to increase proportionally with the CAD severity, the results suggest that DM acts as a geometrically progressive coronary arteriosclerosis promoting factor. The results of our study also suggest that its mechanism includes other factors in addition to abnormal lipid metabolism, and that its manifestation is affected by gender.
