Relationship Between Angiopoietin-like Protein 2 And Carotid Atherosclerosis And The Stability Of Carotid Atherosclerotic Plaques

ObjectiveIn the study,we tested the concentrations of plasma angptl2 in patients with stroke and caretid stenosis,and tested the expression of it in cerotid atherosclarotic plaques.To detarmine the correlationship betwen plasma angptl2 concentretions with the devalopment of cerotid stenosis. And further to investigate whether angptl2 can be a biomarker of early CAS or not and explore the correlationship between angptl2 and stability of CAS plaques at the same time. MethodsTwo hundred patients with CAS that hospitalized in Huanhu hospital were enrolled in the study, whether they have cerabral infarction or not. Patients with early CAS(fifty cases),mild-moderate carotid atherosclerosis(fifty cases),severe carotid atherosclerosis(fifty cases) and carotid atherosclerosis with stroke(fifty cases) were classified by these examination findings, and fifty healthy person were registered as a control group. In the same time, another forty-three subjects after carotid endarterectomy(CEA) from interventional department admitted to our hospital were enrolled in our study. They were separated into stable atherosclerosis plaque group and vulnerable atherosclerosis plaque group according to examination results. Samples were including venous and arterial blood and the carotid atherosclerotic plaques. All clinical information and data were collected and analyzed at the same time.In addition,we scored the neurological function of patients that would have carotid endarterectomy in three days referring to the NIHSS score standard.1.The concenstrations of serum angptl2 were detected by ELISA. Samples were including venous blood of two hundred patients with carotid atherosclerosis and peripheral venous blood and arterial blood of forty-three patients that we enrolled from interventional department.2.We used these carotid atherosclerotic plaques for HE staining and immunohistochemistry was applied to test the angptl2 expression in all plaques. Image Pro Plus software was used for analyzing the expression of angptl2 and the intensity was indicated with the average absorbance values.3.We adopted spss seventeen for the stetistical analysis.Data were assessed with group comparison of variables using t-tests.LSD method was undertaken to evaluate relative expression of human angptl2.The correlation was tested with the Pearson test.We considered a velue of P<0.05 as stetistically significent.Results1.The concentrations of plasma TG and LDL-C in groups with mild-moderate and severe CAS were increased than that in healthy group(P<0.05).The concentrations of serum HCY in patients with severe CAS and CAS with stroke was higher than that in healthy person(P<0.05).2.Serum angptl2 concentretion in groups that with CAS were significently higher then that in the healthy group(P<0.05). Serum angptl2 concentretions in patients with severe CAS and CAS with stroke were significently higher then that in patients with mild-moderate CAS(P<0.05). And there were no obvious differance batween plasma angptl2 concentretions in patients with early cerotid sclerosis and that in petients with mild-moderate CAS(P>0.05).3. Forty-three plaques were classified into stable plaque group(n=16) and unstable plaque group(n=27). There is no significent diffarence in baseline clinical indicator including sex and age between two groups(P>0.05). NIHSS scores and the concentretions of TG,HCYand hs-CRP of vulnerable atherosclerosis plaques were increased than that of stable atherosclerosis plaques(P<0.05).4.The concentration of Angptl2 in venous plasma and the arterial plasma concentration of that in petients with cerotid endarteractomy was positively correlated(r=0.854,P<0.01).The levels of plasma angptl2 in unstable plaques were significantly increased than that in stable plaques(P<0.05).5.Higher expression of Angptl2 was observed in unstable plaques than that in stable plaques(P<0.05). Conclusion1.Dyslipidemia is a initial reason in the pathogenesis of atherosclerotic plaque, and play an critial role in the devalopment of atherosclerosis,as the stenosis is aggravating, levels of TG and LDL-C are on the rise.2.As a new angioganic factor,angptl2 contributas to angioganesis and inflammatory. The level of serum angptl2 has significantly increased in the early CAS. And the level is on rise along with the aggravation of atherosclerosis and carotid stenesis dagree. Thus the concentration of angptl2 can be used as a biomarker of early carotid atherosclerosis.3. Venous plasma level of TG,hs-CRP and HCY were much higher in patients with unstable atherosclerotic plaques.And the unstablity of carotid atherosclerotic plaque is closely correlated with the clinical nerve function defect degress.4. As the venous plasma concentration of Angptl2 increasing, arteriel plasma concentration of that is on rise.Serum angptl2 can indirectly reflect development of CAS and stability of atherosclarotic pleques.Thus venous plasma concentration of angptl2 can be help for the clinial early intervention.