Analysis Of The Association Between The Level Of Serum Liver Enzyme And Coronary Heart Disease

Objective:To study the relationship between the level of serum alanine aminotransferase (ALT)、gamma-glutamyl transpeptidase (GGT)、bilirubin (BI) and coronary heart disease (CHD) and coronary artery stenosis degree.Methods:The case-control study was used and a total of1826patients were recruited in this study from The Second Hospital of Tianjin Medical University in2009-2011. The following indicators were tested in the study, including the level of serum alanine aminotransferase (ALT)、aspartate amino transferase (AST)、total bilirubin (TBIL) direct bilirubin (DBIL)、indirect bilirubin (IBIL)、alkaline phosphatase (ALP)、 gamma-glutamyl transpeptidase (GGT)、total cholestero (TC)、triglycerides (TG)、 Low density lipoprotein cholesterol (LDL-C)、high density lipoprotein cholesterol (HDL-C) and Fasting Plasma Glucose (FPG), and the coronary artery angiography were performed.According to the results of coronary artery angiography, the petients were divided into coronary heart disease group (n=1242) and the control group (n=584), and then the CHD group, diagnosed as CHD by coronary artery angiography, were subdivided into3subgroups of single-branch (n=406), double-branch (n=350) and multiple-branch (n=486); Tested on the results of Gensini integral, we evaluated the lesion degree of coronary and then subdivided the CHD into4groups. The scope are0-1as a(n=482)、2-20as b(n=516)、21-40as c(n=460)、more than40as d (n=368) respectively. The multivariable Logistic regression analysis were used to determine the risk factors for coronary heart disease, and Spearman Rank Correlation were used to analyze the correlation between serum ALT、GGT、BIL and coronary artery stenosis degree.Results:1.The comparison of baseline data in two groupsCompared with the control group, the number of male and smokers are significantly higher in CHD than in controls (p<0.05), There are no significant difference in BMI、age、history of drinking and the proportion of high blood pressure and diabetes (p>0.05)2. The comparison of general clinical data between two groups2.1The level of serum ALT、GGT、TC、LDL-C in CHD group is clearly higher than that of the control group (P<0.01), and the level of serum AST、ALP、TG is also higher (p>0.05)2.2The level of serum TBIL、DBIL、IBIL、HDL-C is obviously lower than that in the control group (P<0.01).3.Comparison of the level of serum ALT、GGT、BIL in three subgroups of CHD and the controls3.1The level of serum ALT、GGT shows a trend of increasing with the increasing of coronary artery lesion counts (P<0.01).3.2The level of serum TBIL、DBIL level shows a trend of decreasing with the increasing of coronary artery lesion counts (P<0.01), the level of serum IBIL shows decreasing, but no significant (p>0.05)4.Comparison of the level of serum ALT、GGT、BIL with Gensini integral4.1The level of serum ALT、GGT shows a trend of increasing with the Gensini integral increased (P<0.01).4.2The level of serum TBIL、DBIL shows a trend of decreasing with the Gensini integral decreased (P<0.05), the level of serum IBIL also decreases, but no significant (p>0.05)5.The correlation between serum ALT、GGT、BIL and FPG、blood lipidsSerum ALT、GGT and FPG、TC、TG、LDL-C were positively correlated, and negatively correlated with HDL-C; serum TBIL and FPG、TC、TG、LDL-C were negatively correlated, and positively correlated with HDL-C.6.The Spearman Rank Correlation between coronary artery stenosis degree and serum ALT、GGT、BILThe level of serum ALT、GGT is positively correlated with coronary artery stenosis degree (p<0.01); The level of serum TBIL、DBIL、IBIL is negatively correlated with coronary artery stenosis degree (p<0.01)7. The multivariable Logistic regression analysis results Except for the traditional risk factors of coronary heart disease, such as sex、 smoking、high cholesterol、low high density lipoprotein cholesterol, the elevated serum ALT%GGT and the low level of serum TBIL are all independent risk factors for coronary heart disease.Conclusions:1. The level of serum ALT、GGT is positively correlated with coronary artery stenosis degree; The level of serum BIL is negatively correlated with coronary artery stenosis degree.2. Elevated level of serum ALT、GGT、and reduced level of serum BIL are closely associated with the occurrence of coronary heart disease; Elevated serum ALT、 GGT and reduced serum TBIL are all independent risk factors for coronary heart disease.3. The level of serum AL、GGT、BIL may provide a new and convenient biochemical indicators for the diagnosis and treatment of coronary heart disease.