| Objective: In recent years, the morbidity and mortality of coronary heart disease(CHD) in our country is on the rise. Coronary heart disease is a multi-etiological factors disease, and the research on the relationship between its risk factors and coronary artery stenosis has become a hot in Epidemiological studies of cardiovascular. Resistin (resistin, RSTN) is a peptide hormone secreted specificity by fat tissue, now it is considered to be relevant to the occurrence and development of obesity, insulin resistance, type 2 diabetes and atherosclerosis.The discovery of resistin provide a new direction for the study on the etiology and prevention of coronary heart disease. More and more evidence shows that as a pro-inflammatory cytokines resistin can promote the expression of inflammatory markers, induce vascular inflammation, lead to impaired endothelial cell function and affect glucose and lipid metabolism by acting on various of insulin target organs , lead to insulin resistance, increase endothelial cell dysfunction, promote the formation of atherosclerosis. While there has been some research that resistin might be involved in the occurrence and development of CHD, but comparative study on resistin and coronary angiography which is the standard for diagnosis of CHD is not more. This study is to investigate the relationship of serum resistin, lipids and other factors with severity of coronary artery stenosis, and to explore the possibility of resistin as a predictor of coronary artery stenosis , accordingly provide the basis for early clinical intervention of risk factors of disease.Methods: 112 patients, diagnosed as CHD ,who were hospitalized in the Cardiology Department of the second hospital of hebei medical university and underwent coronary angiography(CAG) from december 2008 to november 2009 were enrolled in this study (86 male, 26 female, aged 41-77). Selected cases took blood from ulnar vein in the next morning after fasting for 12 hours for testing serum resistin and blood lipid, specifically including:Triglyceride(TG),blood total cholesterol(TC),high density lipoprotein cholesterol (HDL),low density lipoprotein cholesterol(LDL),apolipoprotein A(ApoA),apolipoprotein B(ApoB) and Lipoprotein (a) (Lp (a)). All the cases were measured body height and weight,then BMI was calculated. Coronary angiography was carried by fixed doctors by Judkins method through arteria radialis or arteria cruralis, multi-position projection,and we used Gensini scores for quantitative analysis of all coronary stenosis degree. All cases are grouped according to the following criteria:Significant coronary artery stenosis was defined as≥50% narrowing in the vessel diameter on the coronary angiogram.All patients were divided into non-stenosis group(group 1) or coronary stenosis group(group 2) (defined as at least 1 vessel with coronary artery stenosis≥50%)[including: Single-vessel group(group 2a), double-vessel group (group 2b)and the three-vessel group(group 2c)]. Compare resistin,blood lipid levels among these groups. All statistical analyses were performed using the SPSS 13.0 program package.Data were expressed as the mean value±standard deviation.Data between two groups were compared by t test. And data between Multi-group were compared by single-factor analysis of variance. Sample rate was compared byχ2 test.The relationship between Gensini scores and serum resistin, blood lipids, sex, age, body mass index was analyzed by linear correlation, partial correlation and multiple liner stepwise regression.p<0.05 was considered statistically significant.Results:1. Resistin levels in stenosis group was significantly higher than that of non-stenosis group (9.58±3.23vs4.59±1.30ng/ml),there was highly significant difference(P<0.01). Resistin levels in Single-vessel group, double-vessel group and the three-vessel group were 8.90±3.17ng/ml,9.92±3.41ng/ml and 10.03±3.12ng/ml,and were significantly higher than that of non-stenosis group, there was highly significant difference(P<0.01). Resistin levels was rised with the increase of lesion count,but there was no significant difference(P>0.05). LDL in stenosis group was higher than that of non-stenosis group (2.87±0.79vs2.29±0.63mmol/L),there was significant difference(P<0.05). LDL in double-vessel group and the three-vessel group were both higher than those of non-stenosis group and Single-vessel group(3.01±0.40,3.12±0.99vs2.29±0.63,2.55±0.72mmol/L), there was significant difference(P<0.05). HDL and ApoA in stenosis group were lower than that of non-stenosis group (HDL :1.18±0.14vs1.36±0.14mmol/L, ApoA: 1.09±0.15vs1.27±0.13g/L),there was significant difference(P<0.05). HDL in Single-vessel group, double-vessel group and the three-vessel group were 1.20±0.13mmol/L,1.19±0.12mmol/L,1.16±0.15mmol/L, ApoA in these groups were 1.10±0.15g/L,1.10±0.16g/L,1.08±0.16g/L,and were both lower than that of non-stenosis group, there was significant difference(P<0.05). Lp(a) in stenosis group was significantly higher than that of non-stenosis group (178.84±59.14vs140.00±43.17mg/L),there was highly significant difference(P<0.01). Lp(a) in the three-vessel group was significantly higher than those of non-stenosis group, Single-vessel group, and double-vessel group(200.71±59.25vs140.00±43.17,171.25±59.72,164.62±53.46mg/L), there was highly significant difference(P<0.01). Gender factors (male proportion) in stenosis group was higher than that of non-stenosis group (81.4vs61.5%),there was significant difference(P<0.05). Gender factors (male proportion) in Single-vessel group, double-vessel group, and the three-vessel group were 75.0%,92.3%,78.6%, and were higher than that of non-stenosis group, but there was no significant difference(P>0.05). Age in stenosis group was higher than that of non-stenosis group ( 58.72±9.67vs54.00±5.78years old),there was significant difference(P<0.05). Age in the three-vessel group was higher than that of non-stenosis group(61.89±10.02vs54.00±5.78 years old) , there was significant difference(P<0.05). BMI,TC,TG and ApoB in stenosis group were higher than that of non-stenosis group,but there were no significant difference between these groups (P>0.05). 2. Linear correlation revealed that both resistin and Lp(a) were significant positively associated with coronary score,P<0.01,r=0.372,0.286;Age and LDL were positively associated with coronary score,P<0.05,r=0.283,0.295; HDL and ApoA were negatively associated with Gensini scores,P<0.05,r=-0.230,-0.205. In the correction of gender, age, BMI, lipid factors, resistin and Lp (a) were still positively associated with coronary score, P<0.05, r =0.226,0.209. 3. Multiple linear stepwise regression analysis showed resistin,Lp(a) and age entered the regression equation.The regression equation is:Gensini score=-55.183+2.709RSTN+0.144Lp(a)+0.775Age. Standardized regression coefficients were 0.280,0.240,0.204.Conclusion: 1. Resistin levels in stenosis group was significantly higher than that of non-stenosis group,and its level was rised with the increase of lesion count, in addition,resistin was significant positively associated with coronary score.All of these above suggest that resistin involved in the occurrence and development of CHD; 2. Lp(a) in stenosis group was significantly higher than that of non-stenosis group, and the three-vessel group increased most significantly,moreover,Lp(a) was significant positively associated with coronary score. These results suggest that Lp(a) is a negative factor in occurrence and development of CHD; 3. Multiple linear stepwise regression analysis showed that RSTN, Lp (a) levels and age are factors affecting the degree of coronary stenosis, in which resistin level has the greatest impact on coronary artery stenosis ,suggesting that resistin and Lp (a) are risk factors for coronary artery stenosis, and there may be used as important predictors of the severity of coronary heart disease.
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