Clinical trial of insulin therapy in elderly patients with coronary heart disease combined with type 2 diabetes
Objective This study aimed to investigate the correlation between insulin resistance score after insulin treatment in elderly patients with coronary heart disease and type 2 diabetes mellitus and cardiovascular outcomes.Methods Elderly patients with coronary heart disease complicated with type 2 diabetes mellitus were selected as the study subjects.All enrolled patients received insulin treatment with an initial dose of 3 U,administered subcutaneously before meals.The total daily dose of insulin was controlled at 0.3-0.8 U·kg-1.The occurrence of major adverse cardiovascular events(MACE)was recorded,and the correlation between insulin resistance score(METS-IR)and cardiovascular outcomes,as well as the predictive value for the occurrence of adverse cardiovascular events was analyzed.Results Before and after insulin treatment in elderly patients with coronary heart disease and type 2 diabetes mellitus,the average body mass index(BMI)were(26.03±3.12)and(25.23±0.02)kg·m-2,triglycerides(TG)were(123.60±21.46)and(113.70±19.75)mg·dL-1,total cholesterol(TC)were(155.80±14.19)and(153.40±13.98)mg·dL-1,low-density lipoprotein cholesterol(LDL-C)were(94.58±9.85)and(91.74±9.56)mg·dL-1,high-density lipoprotein cholesterol(HDL-C)were(46.02±4.47)and(49.73±4.83)mg·dL-1,and fasting blood glucose(FBG)were(98.55±10.58)and(93.62±10.05)mg·dL-1,respectively.The METS-IR scores were 39.26±4.80 and 36.89±4.50,respectively.Except for plasma TC,the differences in the above indicators before and after treatment were statistically significant(all P＜0.05).Among the enrolled patients,a total of 48 cases(22.2％)experienced MACE,including 23 cases of hypertension,14 cases of angina pectoris,8 cases of hospitalization for myocardial infarction,3 cases of hospitalization for heart failure.Spearman correlation analysis showed that METS-IR was significantly positively correlated with the incidence of adverse cardiovascular events(P＜0.01).ROC curve analysis indicated that METS-IR had a high predictive value for the occurrence of MACE in elderly patients with coronary heart disease and type 2 diabetes mellitus.Conclusion After insulin treatment in elderly patients with coronary heart disease and type 2 diabetes mellitus,METS-IR was significantly positively correlated with the incidence of adverse cardiovascular events and had good predictive value for cardiovascular outcomes.
insulincoronary heart disease complicated by type 2 diabetes mellitusmetabolic score for insulin resistance
国家科技期刊平台
NSTL
万方数据
维普
