The Relationship Between Plasma Leptin Levels And Inflammatory Markers In Patients With Coronary Atherosclerotic Heart Disease

Objective:Recently,with the change of lifestyle and diet,the incidence of coronary atherosclerotic heart disease(CAD)in China is increasing.As one of the most important risk factors of CAD,obesity rate is positive with that.CAD is based on atherosclerosis in which a variety of inflammatory cells participate.And,chronic inflammation of the obesity can promote body to secrete a variety of inflammatory cytokines,regulating high cholesterol,high blood,diabetes,metabolic syndrome and other diseases.Some studies have reported that inflammation plays an important role in atherosclerotic process.Leptin whose circulating levels increase in proportion to fat mass has an effect on energy balance,appetite control,immune response,angiogenesis and help to regulate body weight.This study explored the association of plasma leptin levels with inflammatory cells,including white blood cell(WBC),neutrophil(NE),lymphocyte(LY)and monocyte(MONO)between underweight or normal weight and overweight or obesity weight,especially in patients of CAD.Methods:Blood plasma samples were obtained from 209 patients who were admitted to the Department of Cardiology for chest pain or chest tightness,undergoing coronary angiography(CAG)or percutaneous coronary intervention(PCI),in Northern Jiangsu People’s Hospital from 1,May to 30,November in 2018.The experiment groups were based on two ways,one was depended on the degree of coronary stenosis according to the result of coronary angiography.As following,if the degree of coronary stenosis was≥ 50%,it would be included in the CAD group(n=111);if the degree was<50%,it would be in the non-CAD group(n=98).The other way are accorded to BMI value.If BMI<25 kg/m2,it was in the underweight or normal body group(n=110),if BMI≥25 kg/m2,it was in the overweight or obese group(n=99).Recording these basic clinical datas of subjects,including gender,age,height,weight,smoking history,history of high blood pressure(HHBP),history of diabetes,blood test indicators such as fasting blood-glucose(FBG),plasma total cholesterol(Total cholesterol,TC),Triglyceride(TG),etc,and coronary angiography results are included.The concentration of leptin in fasting plasma in the morning was detected by enzyme-linked immunosorbent assays(ELISA).The relationship between leptin and WBC,NE,LY and MONO was statistically analyzed by EXCEL,PRISM 7.0 and SPSS 20.0 software,and the factors influencing plasma leptin levels were analyzed by regression analysis.Results:1.Aspartate transaminase(AST),Creatinine(Cre),Low-density lipoprotein cholesterol(LDL-C),Apo lipoprotein A l(Apo Al),Apo lipoprotein B(Apo B),left ventricular ejection fraction(LVEF),gender and smoking status were statistically different between the non-CAD group and the CAD group(P<0.05).There were no significant differences in History of High Blood Pressure(HHBP),Age,Platelet Count(PLC),Fasting blood-glucose(FBG),Triglyceride(TG),Total cholesterol(TC),High density lipoprotein cholesterol(HDL-C),Body Mass Index(BMI)and TyG index(P>0.05).2.Compared to the overweight or obese group(BMI≥25 kg/m2),the difference of age,gender,HHBP,ALT,TG,HDL-C and TyG index in underweight or normal body group(BMI<25 kg/m2)were significant(P<0.05),while there were no significant difference in Cre,TC,LDL-C,Apo Al,Apo B and LVEF(P>0.05).3.Plasma leptin levels in non-CAD group was higher than that in CAD group,but there were no significant difference between these two groups(P=0.059).The concentration of leptin in the overweight or obese group(BMI≥25 kg/m2)was higher than that in underweight or normal body(BMI<25 kg/m2),and the difference was statistically significant(P<0.001).4.The value of WBC(P=0.038),NE(P<0.001)、LY(P=0.001)in Non-CAD group were lower than the CAD group,they were all with statistical difference,MONO was higher than that of CAD group without statistical difference.Underweight or normal body group(BMI<25 kg/m2)subjects’ WBC,NE,LY were lower than that of overweight or obesity group(BMI≥25 kg/m2),MONO was higher than the later,but only MONO had significant statistical difference(P=0.032).5.Depending on BMI=25 kg/m2,when plasma leptin levels were used as the dependent variable,a linear analysis showed that Age,WBC,NE,LY,MONO were positively correlated with the concentration of plasma leptin(P<0.001),Cre was negatively,but with no connection for PLC,TG,TC,HDL-C,LDL-C,Apo Al,Apo B,LVEF and TyG index(P>0.05).6.Using multivariate linear regression to analyze the effect of WBC,NE,LY,and MONO on plasma leptin levels in CAD patients with BMI≥ 25 kg/m2,we established model 1 including age,HHBP;model 2 including age,HHBP,Gender;model 3 including age,history of hypertension,gender,TyG,and then analyzed the effect of WBC,NE,LY,MONO on leptin levels also confounding factors respectively.We found that the WBC,LY,MONO were positively correlated with leptin levels(β>O,P<0.05)while NE was negatively(β<0,P<0.05).HHBP and Gender were independent predictor factors of plasma leptin with significant statistical difference(P<0.05).At last,TyG index hasn’t apparent effect on plasma leptin levels.Conclusions:1.Plsma leptin levels were elevated in the overweight or obese group(BMI≥ 25 kg/m2)compared to underweight or normal weight group(BMI<25 kg/m2);2.WBC,NE,LY,and MONO counts were associated with plasma leptin level in patients with CAD in the overweight or obese group(BMI≥ 25 kg/m2);3.The TyG index of the overweight or obese group(BMI≥25 kg/m2)was higher than that of the underweight or normal body(BMI<25 kg/m2),but in CAD patients with BMI≥25 kg/m2,TyG index has no significant effect on the concentration of plasma leptin and inflammatory markers.