The Correlation On Plasma Homocysteine And Coronary Heart Disease And Its Risk Factors

Objective :Through the analysis of serum homocysteine, blood uric acid and other differences of coronary heart disease(CHD) patients and healthy, to explore the relationship between coronary heart disease(CHD) and homocysteine, uric acid and so on. And to explore the relationship between homocysteine and age, sex, blood lipid, blood glucose, blood uric acid,and other factors, to provides reference of assessing their condition and guiding clinical treatment. Methods:Selected 121 patients with heart disease as text group,who went to cardiology of the First Hospital of Jilin Medical University on June, 2014- December,2015 and knowed its heart whit Coronary angiography. And, selected randomly 200 residents cases of Dehui as control group,who was screened in the survey and haven set up cardiovascular and other diseases. All subjects have been ruled out with severe hepatic insufficiency and renal insufficiency, severe infections, anemia, tumor and autoimmune diseases, the recent oral food and drugs which influence homocysteine levels of,and having a history of trauma and surgery recently. Coronary heart disease patients are divided into simple coronary heart disease(CHD) group, coronary heart disease with hypertension, coronary heart disease with diabetes basing on diagnosis; According to the coronary artery lesion counts divided into single lesion group, the double branch lesions group and multi- branch lesions group.Analyzing the correlation of CHD and homocysteine, uric acid. From 1393 cases of residents who were epidemiological investigated in Dehui region,selection 750 healthful residents, who was explicitly excluded merge history of diseases such as cardiovascular system and other interference factors.The subjects were divided into high homocysteine group(homocysteine level> 15 mmol/L) and normal homocysteine group(homocysteine ≤15 mmol/L),analyzed the relationship between high homocysteine and gender, age, blood pressure, plasma glucose, blood lipids and other biochemical indicators. All data was analyzed by SPSS17.0. Results:1. Coronary heart disease group level of plasma homocysteine(Hcy: 24.92 ± 20.29) and uric acid(UA: 407.72 ± 105.94) higher than the control group(Hcy: 12.20 ± 6.11; UA: 12.20± 90.63), the difference between the two groups(P<0.001). Coronary heart disease with hypertension and coronary heart disease with diabetes levels of plasma homocysteine and levels of uric acid were both higher than simple coronary heart disease(CHD) group levels of plasma homocysteine and uric acid.And, levels of plasma homocysteine and uric acid of simple coronary heart disease(CHD) group is higher than the level of the healthy control group,the difference between the two groups(P < 0.001). Homocysteine levels in the comparison between the coronary artery lesions in each group: multi- branch lesions group(Hcy: 30.24 ± 23.40) > double branch lesion group(Hcy: 24.06 ± 18.92) > single lesion group(Hcy: 17.63 ± 13.68) > the control group(Hcy: 12.20 ± 6.11). The comparison between the uric acid levels on coronary artery lesions in each group : multi- branch lesions group(UA: 446.68 ± 105.19) > double branch lesion group(UA: 400.67 ± 105.41) > single lesion group(UA: 355.44 ± 83.71) > the control group(UA: 306.30 ± 90.63), differences were statistically significant(P<0.001). Plasma homocysteine and levels of uric acid are risk factors of coronary heart disease. To evaluate the value of Hcy to diagnosis of CHD by ROC curve: the area under the ROC curve in diagnosis of CHD was 0.767(95% CI 0.716- 0.818; P < 0.001),of which the best cutoff value was 13.05 umol/L, the sensitivity was 0.736 and specific degree was 0.670.The homocysteine has reference value to the diagnosis of coronary heart disease. 2. Incidence of high homocysteine group in male(63.1%) was significantly higher than incidence of male in healthy controls(37.0%), difference is statistically significant(P<0.001). In age, body mass index, systolic pressure, diastolic blood pressure, high homocysteine groups was higher than normal homocysteine, difference is statistically significant(P < 0.05).Levels of triglycerides, total cholester, low density lipoprotein cholesterol, fasting plasma glucose, plasma uric acid, serum creatinine and urea nitrogen in high homocysteine group were higher than level of the control group, the difference is statistically significant(P<0.05). After adjustment for age and gender, homocysteine was positively correlated with body mass index, diastolic blood pressure, triglycerides, total cholester, low density lipoprotein cholesterol, fasting plasma glucose, plasma uric acid and serum creatinine. Conclusion:1. Homocysteine levels and uric acid levels of coronary heart disease were significantly higher. The more the number of pathological changes of coronary artery, the higher the homocysteine and uric acid levels. Levels of plasma homocysteine and uric acid in coronary heart disease witch associated with complications were both higher than those of mere coronary heart disease. 2. Plasma homocysteine and uric acid are risk factors of coronary heart disease. Hcy have diagnosis value of CHD. 3. Male, smoke and drinking, body mass index, systolic pressure, diastolic blood pressure, triglycerides, total cholester, low density lipoprotein cholesterol, fasting plasma glucose, plasma uric acid, serum creatinine and urea nitrogen were influencing factors of high homocysteine. Homocysteine and body mass index, diastolic blood pressure, triglycerides, total cholester, low density lipoprotein cholesterol, fasting plasma glucose, plasma uric acid, serum creatinine were also correlated.