| Background In traditional concept the pathogenesis of coronary atherosclerotic plaque is inflammation-injury-reaction theory from inside to outside, and vascular endothelial injury is the key factors for triggering the atherosclerosis. Study show that epicardial adipose tissue is adjacent to coronary artery, and it may influence on the pathophysiology of coronary atherosclerotic plaque through releasing cytokines by the way of vasa vasorum or direct infiltration from outside to inside. The change of the volume of epicardial adipose tissue and the expression of cytokines may result in structural and functional change, therefore epicardial adipose tissue become a research focus in nowadays. Some researches show that epicardial fat volume (EFV) is an independent risk factor for coronary heart disease (CHD).Adiponectin is the most widely recognized beneficial adipocytokine to cardiovascular and metabolism. It can only release by adipose tissue. Study show that EFV and the expression of plasma inflammatory cytokine are higher in CHD than in non-CHD. Inflammatory factors expressed in epicardial adipose tissue are higher than subcutaneous adipose tissue, while adiponectin (APN) is on the contrary. Plasma APN is an independent risk factor for CHD. AS a new adipocytokine, C1q/TNF-related protein-9 (CTRP9) and APN all belong to the Clq/CTRP protein family. They have comparable structural domain, and they have the same receptor. Some researches demonstrate that CTRP9 can regulate blood sugar level, improve insulin resistance, inhibit myocardial cells apoptosis after myocardial infarction, and improve cardiac function. It is not clear that the relationship between CTRP9 and EFV, and the influence on CHD and the stability of coronary atherosclerosis plaques.Objective1. This article was to elucidate the effect of plasma CTRP9 and EFV on CHD;2. The impacting of plasma CTRP9 and EFV on coronary stenosis was analyzed;3. This paper was also analyzed the effect of plasma CTRP9 and EFV on stability of atherosclerosis plaque.MethodsPatients who were undergoing coronary angiography and dual-source 64 slices CT were collected from February to October in 2013. According to coronary angiography results they were divided into two groups:non-CHD group (21 cases) and CHD group (67cases). The degrees of coronary artery stenosis were evaluated by Gensini score according to coronary angiography results. EFV and stability of plaque were evaluated by software of SIMENS on the basis of the results of DSCT. CHD group were divided into two groups:vulnerable plaque group (33cases) and non-vulnerable plaque group (34cases). The stability of plaque was evaluated by positive remodeling, spotty calcification and low attenuation plaque. Fasting blood sample were collected for biochemical examination and cytokines by ELISA. Data were statistically analyzed by software of SPSS 16.0.Results1. Numbers of smokers and diabetic in CHD are more than non-CHD; Compare with non-CHD group, LDL-C and EFV of CHD group was significantly higher[(2.480±0.781) and (1.982±0.614), (106.024±40.842) and (83.727±19.692) cm3], P<0.05; Diabetic, LDL-C and EFV were independent risk factors for CHD.2.①Compared with non-CHD, in CHD plasma TNF-a and IL-6 were higher [(9.305±4.081)and(7.444±3.130)pg/ml, (4.362±1.350)and(3.673±0.827)pg/ml], however plasma APN and CTRP9 were lower[(9.262±1.075)and(9.810± 0.707)ng/ml,(78.919±35.572)and(101.031±31.876)pg/ml], P<0.05;②Plasma CTRP9 was positively correlated with APN (r=0.484), however it was negatively correlated with EFV, TNF-a and IL-6 (r=-0.355,-0.259,-0.236), P<0.05;③ Diabetic, LDL-C and plasma CTRP9 were independent risk factors for CHD.3. ①In CHD group, Gensini scores were positively related with EFV(r=0.257), while it was negatively related with CTRP9(r=-0.406). After adjusting for BMI, Gensini scores were still positively related with EFV(r=0.245), and it was negatively related with CTRP9(r=-0.402), P<0.05;②EFV and Low level of plasma CTRP9 were independent risk factors for the severity of coronary artery stenosis in CHD4. ①In CHD group, The level of plasma MMP9、PAPP-A and EFV in vulnerable plaque group were higher than Stable plaque group[(2.271±0.564) and (1.964± 0.554) ng/ml, (105.182±41.618) and (69.794±44.062) ng/ml, (130.297± 40.297)and (82.465±24.504) cm3], while CTRP9 and APN were lower[(67.672± 32.873) and (89.834±35.123) pg/ml, (8.723±0.955) and (9.785±0.925)ng/ml], (P< 0.05);②In CHD group, plasma CTRP9 was positively correlated with APN (r=0.469), while it was negatively related with EFV, MMP9, PAPP-A(r=-0.273,-0.248,-0.294),(P<0.05).Conclusion1. EFV could prompt the happen of CHD, the severity of coronary artery stenosis and the vulnerability of plaque;2. Plasma CTRP9 had a protective effect on CHD, the severity of coronary artery stenosis and stability of plaque;... |
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