Character Of Coronary Atheriosclerosis And Plaque In Type 2 Diabetic Patients With Coronary Heart Disease And Its Relationship With Metrix Metalloproteinase 9

Objective To explore the characters of coronary atheriosclerosis and plaque in type 2 diabetic patients with coronary heart disease and to analyze the relationship between metrix metalloproteinase 9(MMP-9) and fasting plasma glucose(FPG), blood lipid and fasting plasma insulin(FINS).Methods Coronary angiography (CAG) and intravascular ultrasound was done on 40 type 2 diabetic patients with coronary heart disease (CHD) and 40 patients with CHD only. At the same time , FPG, cholesterol (TCH), triglyceride (TG), high-density lipoprotein cholesterol(HDL-C), low-density lipoprotein cholesterol(LDL-C) were measured by biochemical methods, fasting insulin(FINS) by radioimmunoassay and MMP-9 by enzyme linked immuno sorbent assay(ELISA). The data were assessed by chi-square test, t-test and multiple stepwise regression analysis.Results 1. In all patients, the number of unstable plaque diagnosed with IVUS was significantly higher than that with CAG(0.95+0.84 vs 0.68 0.73, P=0. 028). 2. The cases with three coronary segments damaged, three plaques checked by CAG or 2 unstable plaques checked by IVUS and more in group T2DM with CHD were respectly more than those in group CHD[16/40 (40%) vs 9/40 ( 22.5% ) , 15/40 ( 32.5% ) vs 10/40 ( 25% ) , 11/40 ( 27.5% ) vs 5/40 (12. 5%) , respectly], but there was no significant difference. The levels of MMP-9 in the two groups were 47.49 + 16.15ng/ml , 43.86 14.29 ng/ml respectively, there was no significant difference also(P=0. 291). Compared the levels of MMP-9 in sub-group of unstable angina(UA) with sub-group of stable angina(SA), there was significant difference in group CHD or group T2DM with CHD (53. 20+14. 63ng/ml vs 27. 43 4. 33 ng/ml, p<0. 001; 51. 76+12. 28 ng/ml vs 35. 53 9. 914 ng/ml, P<0. 001, respectly). Analyzed after the twogroup were combined, the result showed that there was significant difference in the level of MMP-9 between group UA and group SA(52. 59+13. 59ng/ml vs 33. 22 9. 36, P<0. 001) . 3. The data analyzed by linear regression demonstrated that the level of MMP-9 was correlated with the number of coronary segments damaged and/or unstable plaque(P<0. 001), had no relation to FINS, FPG, HbA,c and HOMA-IR. 4. The data analyzed by multiple stepwise showed that the serum level of MMP-9 was positively correlated with the number of unstable plaque. Conclusion IVUS is superior to CAG on the diagnosis of unstable arteriosclerosis plaques. The serum level of MMP-9 is related to the unstable angina and the number of unstable plaques of coronary .The determination of the level of MMP-9 would contribute to determine the degree of the severity of the coronary atheriosclerosis direct the early determination of the acute coronary syndromes in type 2 diabetic patients with CHD.