Case Control Study
Copyright ©The Author(s) 2023.
World J Diabetes. Dec 15, 2023; 14(12): 1754-1765
Published online Dec 15, 2023. doi: 10.4239/wjd.v14.i12.1754
Table 1 Demographic characteristics in diabetic coronary artery disease patients and non-diabetic coronary artery disease patients
Parameter
Group I, n = 100
Group II, n = 100
P value1
Age54.2 ± 10.253.2 ± 10.30.4732
Male:Female81 (81%): 19 (19%)89 (89%): 11 (11%)0.823
Non-vegetarian diet80%60%0.0013
Smoker65%50%0.0223
Alcohol consumption26%25%0.5003
Tobacco chewer49%39%0.1003
Hypertensive39%20%0.0013
Systolic blood pressure in mmHg as median125.5 (118.0-140.0)120.0 (114.0-129.5)0.0014
Diastolic blood pressure in mmHg as median80.0 (72.0-84.0)80.0 (70.0-80.0)0.0894
Medications
    Statin79%89%0.0413
    Beta-blocker58%73%0.0183
    ACE inhibitor17%5%0.0053
1P value < 0.05 is considered significant.
2Student’s t test.
3χ2 test.
4Mann Whitney U test. Group I: Diabetic coronary artery disease patients.
Group II: Non-diabetic coronary artery disease patients. ACE: Angiotensin converting enzyme.
Table 2 Cardiovascular characteristics in diabetic coronary artery disease patients and non-diabetic coronary artery disease patients
Parameter
Group I, n = 100
Group II, n = 100
P value1
Angiography findings
    Single vessel disease57 (57%)35 (35%)0.0162
    Double vessel disease 27 (27%)36 (36%)
    Triple vessel disease 8 (8%)15 (15%)
    Normal angiogram8 (8%)14 (14%)
    Stenosis in LAD as %90.51 ± 8.5187.85 ± 12.310.053
    Stenosis in LCX as %90.91 ± 8.8082.22 ± 22.330.233
    Stenosis in RCA as %90.32 ± 10.1589.26 ± 12.900.733
    Gensini score26 (12-44)20 (12-40)0.473
2D echocardiography parameters
    Left atrium diameter in cm2.93 ± 0.322.83 ± 0.390.013
    Aortic root diameter in mm2.15 ± 0.392.10 ± 0.400.273
    LVEF45.60 ± 12.0446.70 ± 12.010.493
    Preserved ejection fraction, LVEF ≥ 50%38 (38%)43 (43%)0.692
    Mild ejection fraction, LVEF 41%-49%13 (13%)14 (14%)
    Reduced ejection fraction (LVEF < 40%)49 (49%)43 (43%)
    AWMI39 (39%)39 (39%)0.562
    IWMI26 (26%)21 (21%)
1P value < 0.05 is considered significant.
2χ2 test.
3Mann Whitney U test.
Group I: Diabetic coronary artery disease patients; Group II: Non-diabetic coronary artery disease patients. AWMI: Anterior wall myocardial infarction; IWMI: Inferior wall myocardial infarction; LAD: Left anterior descending; LCX: Left circumflex; LVEF: Left ventricular ejection fraction; RCA: Right coronary artery.
Table 3 Biochemical parameters in diabetic coronary artery disease patients and non-diabetic coronary artery disease patients
Biochemical parametersGroup I, median (25%-75% quartile)Group II, median (25%-75% quartile)P value1
Total cholesterol in mg/dL143.50 (118.00-183.50)132.00 (100.25-163.75)0.0062
Triglycerides in mg/dL150.00 (106.25-214.00)114.00 (75.00-148.75)0.0012
HDL-C in mg/dL33.40 (27.33-38.98)34.55 (28.70-41.00)0.4492
LDL-C in mg/dL78.00 (53.50-108.80)73.00 (52.00-92.75)0.2782
VLDL-C in mg/dL29.00 (20.85-42.00)23.00 (15.00-30.00)0.0012
Random blood sugar in mg/dL213.00 (131.50-275.75)113.00 (99.00-135.00)0.0012
HbA1c as %8.09 (7.10-10.20)5.70 (5.40-5.98)0.0012
Urea in mg/dL29.00 (23.00-39.60)28.55 (24.85-34.00)0.1772
Creatinine in mg/dL0.90 (0.80-1.20)1.00 (0.80-1.10)0.8112
Total bilirubin in mg/dL0.40 (0.30-0.70)0.50 (0.40-0.69)0.2602
Total protein in gm/dL7.10 (6.80-7.60)7.10 (6.73-7.48)0.4412
Albumin in gm/dL4.20 (4.00-4.40)4.28 (4.00-4.50)0.2812
ALP in U/L108 (87.00-133.00)95.50 (84.25-110.00)0.0542
SGOT in U/L26 (21.00-45.00)30.00 (22.00-47.50)0.2402
SGPT in U/L28 (20.00-43.00)29.95 (22.00-49.00)0.1872
Sodium in mEq/L136.00 (134.00-139.00)139.00 (136.00-141.00)0.0012
Potassium in mEq/L4.60 (4.30-4.90)4.35 (4.10-4.80)0.0022
CML in ng/mL264.43 (193.19- 364.34)250.68 (195.95-333.70)0.0312
IL-6 in pg/mL2.75 (1.36-5.50)2.36 (1.23-3.60)0.0112
TNF-α in pg/mL20.2 (13.65-25.32)15.67 (11.137-21.785)0.0062
Nitric oxide in nmol/mL87.09 (59.84-124.37)110.86 (77.00-150.00)0.0022
1P value < 0.05 is considered significant.
2Mann Whitney U test.
Group I: Diabetic coronary artery disease patients; Group II: Non-diabetic coronary artery disease patients. ALP: Alkaline phosphatase; CML: Nε-carboxymethyl-lysine; HbA1c: Glycosylated hemoglobin; HDL-C: High-density lipoprotein cholesterol; IL-6: Interleukin-6; LDL-C: Low-density lipoprotein cholesterol; SGOT: Glutamic-oxalacetic transaminase; SGPT: Glutamic-pyruvic transaminase; TNF-α: Tumor necrosis factor-alpha; VLDL-C: Very low-density lipoprotein cholesterol.
Table 4 Percentage of dyslipidemia in diabetic coronary artery disease patients and non-diabetic coronary artery disease patients
Parameter
Group I
Group II
P value1
High total cholesterol, > 200 mg/dL17 (17%)8 (8%)0.043
Normal total cholesterol, < 200 mg/dL83 (83%)92 (92%)
High triglycerides, > 150 mg/dL49 (49%)24 (24%)0.001
Normal triglycerides, < 150 mg/dL51 (51%)76 (76%)
Low HDL-C, < 40 mg/dL86 (86%)73 (73%)0.017
Normal HDL-C, > 40 mg/dL14 (14%)27 (27%)
High LDL-C, > 100 mg/dL70 (70%)80 (80%)0.094
Normal LDL-C, < 100 mg/dL30 (30%)20 (20%)
1P value < 0.05 is considered significant. Group I: Diabetic coronary artery disease patients; Group II: Non-diabetic coronary artery disease patients. HDL-C: High-density lipoprotein cholesterol; LDL-C: Low-density lipoprotein cholesterol.
Table 5 Correlation analysis of Nε-carboxymethyl-lysine with inflammatory markers, nitric oxide, Gensini score, and biochemical parameters
ParameterSubcategoryCombined (group I and group II)
Group I
Group II
Correlation coefficient
P value
Correlation coefficient
P value
Correlation coefficient
P value
CMLGensini score0.1930.0060.0560.5770.3530.001
IL-60.5960.0010.5020.0010.6730.001
TNF-α0.3370.0010.2560.010.4360.001
Nitric oxide-0.4160.001-0.4840.001-0.2830.004
TC0.2160.0020.250.010.1090.281
Triglycerides0.1560.0270.0870.3890.1690.093
HDL-C-0.0640.372-0.1050.2980.0060.953
LDL-C0.2510.0010.2890.0030.1510.134
VLDL-C0.1310.0650.0450.6540.1760.081
Random blood sugar-0.0110.875-0.2040.0520.0810.43
HbA1c0.140.0480.0060.9510.0440.66
Urea-0.0040.953-0.0060.957-0.0460.653
Creatinine0.0590.4050.1290.202-0.0470.646
Total bilirubin0.0530.4580.0830.4130.080.428
Total protein0.0860.2290.1830.07-0.0550.585
Albumin0.0620.3870.2010.046-0.0640.525
Alkaline phosphatase0.0420.5560.0030.9750.0330.743
SGOT-0.0610.395-0.0560.581-0.0320.754
SGPT0.0190.7930.1020.317-0.0270.788
Sodium0.0220.7620.0590.5590.0790.432
Potassium0.1160.1030.0760.4520.1020.313
Duration of diabetes--0.4940.001--
Group I: Diabetic coronary artery disease patients; Group II: Non-diabetic coronary artery disease patients. CML: Nε-carboxymethyl-lysine; HbA1c: Glycosylated hemoglobin; HDL-C: High-density lipoprotein cholesterol; IL-6: Interleukin 6; LDL-C: Low-density lipoprotein cholesterol; SGOT: Glutamic-oxalacetic transaminase; SGPT: Glutamic-pyruvic transaminase; TC: Total cholesterol; TNF-α: Tumor necrosis factor-alpha; VLDL-C: Very low-density lipoprotein cholesterol.
Table 6 Logistic regression analysis of Nε-carboxymethyl-lysine for risk of diabetic coronary artery disease
Risk model
CML quartile (range) (group I, n; group II, n)
Exp (B)
95%CI (lower-upper)
Significance
Model 1: UnadjustedCML first quartile (83.73-193.18 ng/mL) (group I, n =27; group II, n =23)RefRefRef
CML second quartile (193.19-264.42 ng/mL) (group I, n = 16; group II, n = 34)0.850.48-1.480.57
CML third quartile (264.43-364.31 ng/mL) (group I, n = 23; group II, n = 27)2.121.17-3.850.01
CML fourth quartile (364.32-665.00 ng/mL) (group I, n = 34; group II, n = 16)1.170.67-2.040.57
Model 2: Model 1 + age + sex + non-vegetarian diet + hypertensionCML first quartile (83.73-193.18 ng/mL)RefRefRef
CML second quartile (193.19-264.42 ng/mL)0.570.27-1.230.15
CML third quartile (264.43-364.31 ng/mL)3.051.31-7.060.01
CML fourth quartile (364.32-665.00 ng/mL)1.810.82-3.990.13
Model 3: Model 2+ total cholesterol + triglycerides + LDL-C + IL-6 + TNF-αCML first quartile (83.73-193.18 ng/mL)RefRefRef
CML second quartile (193.19-264.42 ng/mL)0.840.35-2.020.70
CML third quartile (264.43-364.31 ng/mL)3.321.30-8.440.01
CML fourth quartile (364.32-665.00 ng/mL)2.491.03-6.040.04
Group I: Diabetic coronary artery disease patients; Group II: Non-diabetic coronary artery disease patients. CI: Confidence interval; CML: Nε-carboxymethyl-lysine; IL-6: Interleukin 6; LDL-C: Low-density lipoprotein; TNF-α: Tumor necrosis factor-alpha.