The Correlation Investigation On Inflammation Cytokine And Sex Hormone Of Male Coronary Heart Disease Patients

Background: Coronary Atherosclerotic Heart Disease, in short coronary heartdisease, has now become one of the main diseases which threaten people's health. Inrecent years, with the continuous development of people's experiments and clinicresearches on Cardiovascular Diseases, quite a lot scholars propose thatAtherosclerosis is a kind of chronic inflammation and Autoimmune Disease. Therelationship between sex hormone and inflammation gene arouses people's attention,but no unanimous conclusion has been reached. The sex differentiation for theincidence of coronary heart disease is one of the hot topics for researches in recentyears. Even if other factors for incidence are considered, male gender is still theindividual dangerous gene for the incidence of cardiovascular diseases. This cluesthat certain relationship exists between sex hormone and cardiovascular diseases.Inflammatory reaction plays a very important role for the incidence and evolution ofCoronary Atherosclerotic Heart Disease and relevant syndrome. We have done someresearches on the relationship between inflammation gene and coronary heart disease.At present, there is no verdict on the relationship between sex hormone andinflammation gene. There are relevant reports about menopause females but reportson the relationship between sex hormone and inflammation gene in terms of internal environment are rare both in China and abroad. This research made relevant analysison mensurations of male estrogen,testosterone,hs-CRP,MMP-9,PAPP-A,â…¡asPLA2 to prove the relationship between sex hormone and inflammation gene ofcoronary syndrome patients. This research also discussed the possibility of therelevant changes of endogenesis sex hormone and inflammation genes for thediagnosis of coronary heart disease and value of evaluation.Objective: This study is designed to investigate the difference of peripheralserum E₂,T,hs-CRP,MMP-9,PAPP-A andâ…¡a sPLA₂ levels in different subtype ofACS and a study on association of sex hormone of inflammation and male coronarydisease.Method: 68 patients(choose from 301 hospital, period from October of2005 to November of 2005) with CHD were divided into stable angina(SA)group(20 patients),unstable angina (UA) group (25 patients),acute myocardialinfarction (AMI) group (23 patients), after check the clinical presentation,electrocardiogram,biochemical markers for myocardium necrosis.15 subjects(choose from 301 hospital)who underwent body check but showed no evidence ofCHD served as normal control group. The levels of serum E₂,T,and hs-CRP weremeasured by immunoturbidimetry assay and MMP-9,PAPP-A,â…¡a sPLA₂ weremeasured by ELISA.Results: serum hs-CRP was increased stepwise according to the sequences ofcontrol group,SA group,UA group,AMI group. Compared with the controlgroup, serum hs-CRP level was markedly increased in ACS patients (P＜0.01,P＜0.01), and no significant difference was found between AMI group and UA group,and no significant difference was found between SA group and the control group (P=0.459). serum PAPP-A was increased stepwise according to the sequences ofcontrol group,SA group,UA group,AMI group. Compared with the control group, serum PAPP-A level was markedly increased in ACS patients (P＜0.01,P＜0.01), and no significant difference was found between AMI group and UA group,,and no significant difference was found between SA group and control group (P=0.864) .serum MMP-9was increased stepwise according to the sequences of controlgroup, SA group, UA group,AMI group. Compared with the control group, serumMMP-9 level was markedly increased in ACS patients (P＜0.01, P＜0.01), and nosignificant difference was found between AMI group and UA group, and nosignificant difference was found between SA group and the control group (P=0.234).serumâ…¡a sPLA₂ was increased stepwise according to the sequences of controlgroup,SA group,UA group,AMI group. Compared with the control group, serumâ…¡a sPLA₂ level was markedly increased in ACS patients (P＜0.01, P＜0.01), and nosignificant difference was found between AMI group and UA group, and nosignificant difference was found between SA group and control group (P=0.664). serum E₂ was increased stepwise according to the sequences of controlgroup,SA group,UA group,AMI group. Compared with the control group, serumE₂ level was markedly increased in ACS patients (P＜0.01, P＜0.01), and nosignificant difference was found between AMI group and UA group, and significantdifference was found between SA group and the control group (P=0.040) . serum Twas increased stepwise according to the sequences of control group,SA group,UAgroup,AMI group. Compared with the control group, serum T level was markedlyincreased in ACS patients (P＜0.01, P＜0.01), and no significant difference wasfound between AMI group and UA group, and no significant difference was foundbetween SA group and the control group (P=0.439). serum E₂/T was increasedstepwise according to the sequences of control group,SA group,UA group,AMIgroup. Compared with the control group, serum E₂/T level was markedly increasedin ACS patients (P＜0.01, P＜0.01), and no significant difference was found between AMI group and UA group, and significant difference was found between SA groupand the control group (P=0.000).The correlation analysis in ACS group showed that there was a correlationbetween hs-CRP and MMP-9 (r=0.217, P=0.049). There was a significantcorrelation between hs-CRP and PAPP-A (r=0.244, P=0.026). There was nosignificant correlation between hs-CRP andâ…¡a sPLA₂ (r=0000, P=0.976). Therewas a significant correlation between MMP-9 and PAPP-A (r=0.320, P=0.003)There was a significant correlation between MMP-9 andâ…¡a sPLA₂ (r=0.265,P=0.016). There was a significant correlation between PAPP-A andâ…¡a sPLA₂ (r=0.370, P=0.001).There was a significant correlation between E₂ and hs-CRP (r=0.332,P=0.002). There was a significant correlation between E₂ and PAPP-A (r=0.436,P=0.000). There was no significant correlation between E₂ and MMP-9 (r=0.152,P=0.171). There was a significant correlation between E₂ andâ…¡a sPLA₂ (r=0.321,P=0.003). There was no significant correlation between T and hs-CRP (r=-0.200,P=0.070). There was a significant correlation between T and PAPP-A (r=0.232,P=0.035). There was a significant correlation betweenT and MMP-9 (r=0.297,P=0.0061). There was a significant correlation between T andâ…¡a sPLA₂ (r=0.332,P=0.002). There was no significant correlation between E₂/T and hs-CRP (r=-0.139,P=0.211). There was no significant correlation between E₂/T and PAPP-A (r=-0.195, P=0.078). There was a significant correlation between E₂/T and MMP-9(r=-0.303, P=0.005). There was no significant correlation between E₂/T andâ…¡asPLA₂ (r=-0.170, P=0.124).Conclusions: This study showed that serum hs-CRP,PAPP-A,MMP-9,â…¡a sPLA₂ levels were elevated in ACS group, suggesting the serum hs-CRP,PAPP-A,MMP-9,â…¡a sPLA₂ levels may reflect the severity of ACS and inflammation factors have relationship with plaque unstable and reflect the activitiesof plaque indirectly. Study indicated that sex hormone was obviously correlated withcoronary disease,the increase of E₂ and decrease ofactivity of testosterone was one ofpathogenetic factors of male CHD.