In a total of 320 consecutive patients with T2DM, coronary angiography revealed normal coronary arteries in 83 patients (control group) and significant
coronary stenosis (> or = 70%
luminal diameter narrowing) in 237, of whom 51 patients had 1-vessel disease (Group I), 80 had 2-vessel disease (Group II), and 106 had 3-vessel disease (Group III).
Serum glycated albumin,
hemoglobin A(1c) (HbA(1c)) and
tumor necrosis factor (
TNF)-alpha levels,
lipid profile, and renal function were measured. Logistic regression analysis was performed to determine the relative risk of
serum glycated albumin level for the presence and severity of CAD. Multivariate stepwise linear regression analysis was done to identify independent determinants of the glycated
albumin level.
Serum glycated albumin (21.2+/-5.3% vs 19.4+/-4.3%, p=0.005) and
TNF-alpha levels (123 +/-115 pg/ml vs 65+/-59 pg/ml, p<0.001) were significantly higher in patients with CAD than in controls, but serum HbAlc level did not significantly differ between them (7.6+/-1.3% vs 7.4+/-1.2%, p=0.19). There was a significant difference in
serum glycated albumin level between Groups I and III (19.5+/-3.3% vs 21.8+/-5.7%, p<0.001). The
serum glycated albumin level correlated with the number of diseased arteries (Spearman r=0.205, p<0.001), and was closely related to serum levels on admission of
glucose (r=0.495, p<0.001),
TNF-alpha (r=0.123, p=0.028), blood
urea nitrogen (r=0.167, p=0.004),
triglycerides (r=0.129, p=0.021), and HbA(1c) (r=0.795, p<0.001). Multivariate analysis indicated that serum levels of
glucose (p<0.0001),
TNF-alpha (p=0.001), blood
urea nitrogen (p=0.004) and
triglycerides (p=0.035) were independent determinants for glycated
albumin. Logistic regression analysis revealed that glycated
albumin > or = 19% (odds ratio (OR) 2.9, p<0.001) was an independent predictor for CAD and glycated
albumin > or = 21% (OR 2.3, p=0.032) for 3-vessel disease prediction. The area under the receiver-operating characteristic curve for glycated
albumin (0.620, 95% confidence interval (CI) 0.548 to 0.691, p=0.001) was superior to that for HbA(1c) (0.543, 95% CI 0.473 to 0.613, p=0.243).
CONCLUSIONS: