Association Of Serum CTRP6 Level With High-sensitive C-reactive Protein In Coronary Artery Heart Disease

Background: Coronary artery heart disease refers to coronary stenosis or occlusion caused by coronary atherosclerosis,leading to myocardial ischemia and hypoxia caused by heart disease,coronary functional changes and it namely coronary artery spasm together,collectively referred to as coronary heart disease(CHD).In today's world it belongs to one of the major killer diseases in Western countries,the total annual mortality rate of about 1/3 of mortality,accounting for 50%-75% of heart disease mortality,despite some strong and effective interventions for secondary prevention of coronary heart disease mortality risk factors so began to decline,but according to WHO statistics,coronary heart disease is still the most common cause of death,exceeded the sum of all cancer mortality,the cause of death of the first column to human life posed a serious security threat.Acute coronary syndrome(ACS)is a common clinical emergency,has the characteristics of sudden onset and high mortality,it can be divided into without ST-segment elevation ACS and ST segment ACS,the former includes unstable angina(UA),non-ST-segment elevation myocardial infarction(NSTEMI),which is the occurrence plaque rupture and erosion,platelet aggregation and thrombosis,vasoconstriction mainly based on the pathogenesis of coronary atherosclerosis,as a result of acute or sub acute myocardial oxygen supply is reduced.Thus further study of its pathogenesis,to find more effective intervene and targets has become a hot topic in the field of cardiovascular research in recent years.For a long time,high sensitive C-reactive protein,(hs-CRP)has been applied to the diagnosis and monitoring of their own immune diseases and infectious diseases in clinical,in recent decades hs-CRP is used as a sensitive marker of tissue damage,and with the development of coronary heart disease-related,it is considered one of serological markers of atherosclerosis in relation to most closely.In recent years,serological markers as predictors of coronary heart disease are becoming a useful tool for those who get medical attention.The close relationship between fat and coronary heart disease factors gradually been recognized.Adiponectin(APN)in the fat cells of the most representative factor family,close ties with cardiovascular disease,there are a large number of studies have shown that adiponectin has vasodilator,anti-inflammatory,anti-atherosclerotic effect.Newly discovered adipokines C1 q / TNF-related protein 6(CTRP6)is a protein closed with APN in structural and function,but the research between CTRP6 with atherosclerosis has not been reported,so in-depth study the relationship between CTRP6 and coronary heart disease is important for comprehensive understanding of CTRP6,and explore new targets for the interventions of coronary heart disease.Objective: To investigate the association of the serum CTRP6 and hs-CRP with the severity of the coronary artery steno-sis by measuring the serum level of the CTRP6 and hs-CRP in different types of coronary heart disease(CHD)and exploring the correlation between the two indices.Methods:1 A total of 123 patients from the cardiovascular department of the second hospital of Hebei Medical University from June 2015 to December 2015 were performed by the coronary artery angiography(CAG),male 68 cases,female 55 cases,the average age(59.41 ± 10.8)years old.The clinical basic information of all subjects,including age,gender,hypertension history,and diabetes history,was clearly recorded.The serum level of the biochemical indexes,including Body-mass index(BMI),Total cholesterol(TC),Triglyceride(TG),Low density lipoprotein cholesterol(LDL-C),High density lipoprotein cholesterol(HDL-C),lipoprotein(a)and Fasting plasma glucose(FPG),was also determined.2 According to the results of coronary angiography(CAG),123 patients were divided into coronary heart disease(CHD)group(n=92)and CAG without steno-sis of the normal control group(n = 31).The CHD group based on clinical symptoms was divided into stable angina pectoris(SAP group,n= 18),acute coronary syndrome group(ACS group,n=74),patients with ACS including unstable angina group(UAP group,n = 51)and acute myocardial infarction(AMI group,n= 23).On the basis of SYNTAX score evaluation of coronary artery lesion severity,and according to the results,the CHD group was divided into three groups,including SYNTAX low score group(n=32),SYNTAX medial score group(n=37),SYNTAX high score group(n=23).CHD group was also according to coronary artery lesions divided into single-vessel disease group(n = 39),double vessel disease group(n = 31),three-vessel disease group(n = 22).3 Extract the patients' vein blood before 8 hours of fasting venous blood preoperative,at the same time using enzyme-linked immunosorbent assay(ELISA)method for determination of all subjects' serum CTRP6 and high-sensitivity C-reactive protein levels.Compare the patients' serum CTRP6 and high-sensitivity C-reactive protein levels in different groups of CHD,and predict the potential value in severity of coronary artery disease.Results:1 There were no significant differences between the CHD group and the non-CHD group in the baseline characteristics such as age,gender,hypertension history,diabetes history,BMI,Total cholesterol(TC),Triglyceride(TG),High density lipoprotein cholesterol(HDL-C),Low density lipoprotein cholesterol(LDL-C),lipoprotein(a),FPG(P>0.05).2 In ACS group,CTRP6 level was significantly lower than the control group(P <0.01)and SAP(P <0.05),the AMI group CTRP6 level was significantly lower than the UAP group(P <0.01)in ACS group.In SAP group CTRP6 level was significantly lower than the control group(P <0.05).3 In CHD group,CTRP6 level of SYNTAX high score group was significantly lower than the SYNTAX medial score group and SYNTAX low score group(P <0.01),SYNTAX medial score group was significantly lower than the SYNTAX low score group(P<0.01),CTRP6 level was negatively correlated with SYNTAX score(r =-0.741,P<0.01).4 In CHD group,the serum level of the CTRP6 in the multivessel disease group was significantly lower than that in the double vascular disease group(P<0.05),the serum level of the CTRP6 in the double vascular disease group and multivessel disease group was significantly lower than that in the single vascular disease group(P<0.05),the serum CTRP6 level of in the single vascular disease group,the double vascular disease group and the multivessel disease group was significantly lower than that in the non-CHD group(P<0.05).5 The serum CTRP6 levels was negatively correlated with hs-CRP levels in coronary heart disease(r=-0.648,P<0.01).Conclusions:The serum CTRP6 level was negatively correlated with the lesions degree of the coronary artery disease.the coronary lesions more severe,the lower of serum CTRP6 expression levels,with the heavier group SYNTAX score,the lower level of serum CTRP6,and in patients with coronary heart disease,serum CTRP6 level was negatively correlated with hs-CRP,serum CTRP6 level reducing may be contributed the development and progression of coronary heart disease.