Association Between Plasma Level Of Omentin And Severity Of Coronary Artery Disease On Female Individual

BackgroundCoronary heart disease,as one of the major threats to human cardiovascular health,is characterized by high mortality and disability.During peri menopause,the levels of hormones in women change dramatically,leading to abnormal glucose and lipid metabolism and damage to endothelial cell function,follower by increased risk of coronary heart disease.Clinical studies have shown that the average age of woman with coronary heart diseuses is younger,but research on female population with coronary heart disease is still imsufficient,as well as research on new predictors.In addition to traditional risk factors,such as diabetes、hypertension、smoking history、hyperlipidemia and family history,etc.,this study attempts to focus on other aspects of physiological and biochemical mechanisms at a deeper level.Adipokine is a type of endocrine factor secreted by adipose tissue.It is widely involved in physiological processes of metabolic processes、angiogenesis and inflammation in the body.Recently,it gradually hikes into the spotlight in research field of MetS、Diabetes and cardiovascular diseaseAdipokine target cells are distributed in skeletal muscle、liver、pancreatic βcells、and endothelial cells,playing an important role in insulin resistance.The mechanism of regulating energy metabolism may be mediated by activated protein kinase(AMPK).It can inhibit energy-consuming synthetic reactions,such as protein synthesis and lipid synthesis,by increasing blood glucose uptake、fatty acid oxidation and inhibiting the activation of TNF-α induced by COX-2 activation,leading to activation of endothelial nitric oxide synthase(eNOS/NO),and it can also exert anti-inflammatory activity after blocking the JNK signaling pathway.Depending on structure and physiological functions,adipokines can be roughly divided into two categories:insulin-sensitizing factors and insulin-resistance-inducing factors.By the locality of secretion,adipokines can be divided into organal and adipose tissue surrounding organs,white adipose tissue and brown adipose tissue.Omentin is a new type of adipokin,which was formally isolated from Paneth cells in the small intestine,so it was named intelectin-1.In many studies on obesity and insulin resistance,its serum level is negatively correlated with the severity of the disease course,and it is significantly positively correlated with the insulin sensitizing factor adiponectin and high density lipoprotein.Today,some studies indicate that low levels of adiponectin are closely related to the occurrence and development of cardiovascular disease,but domestic research on omentin has mostly focused on endocrine diseases such as female polycystic ovary syndrome、diabetes and obesity.Study on the correlation between plasma omentin circulation level and the severity of cardiovascular disease is still insufficient.The purpose of this study was to investigate the differences in the expressions of omentin and adiponectin in serum of female patients with coronary heart disease and their possible influencing factors,as well as the predictive value and potential therapeutic significance of omentin in assessing the severity of diseaseObjectiveIn this study,we compared the changes in serum levels of omentin and adiponectin in women with three-vessel coronary disease and women with non-three-vessel coronary disease,as well as in the normal control group.To explore the predictive value and potential therapeutic effect of omentin in patients with coronarien diseuse.Methods133 women with ACS diagnosed by CAG in Cardiology Apartment of First Affiliated Hospital of Zhengzhou University from December 2018 to January 2019 were enrolled and were grouped into three-vessel(n=60)and nonthree-vessel(n=73).Another 96 normal coronary women without ischemic ECG confirmed by CAG and matched by age were recruited for controlled group.Coronary heart disease diagnostic criteria:Coronary angiography shows that at least one of the left main trunk,left anterior descending branch,circumflex branch,or right coronary artery has a stenosis of ≥50%.Three-vessel disease refers to anterior descending branch,left circumflex branch and right coronary artery or their main branches with stenosis≥50%at the same time.Detailed records of the demographic data and baseline data of the selected subjects were collected.Data inclues gender,age,smoking history,long-term medication history,and whether complicated with diabetes,hypertension,hyperlipidemia,and so on.Biochemical indicators such as omentin,adiponectin,high-density lipoprotein cholesterol,low-density lipoprotein cholesterol,and glycated hemoglobin were measured.The degree of coronary stenosis was analyzed according to the results of coronary angiography,and the Gensini score was recorded.The levels of omentin,adiponectin,high-density lipoprotein cholesterol,low-density lipoprotein cholesterol,glycated hemoglobin,and Gensini score among the groups were compared for statistical analysis by SPSS 2 1.0.Normally distributed measurement data are shown by x±s.ANOVA is used for comparison of measurement data between multiple groups,and Bonferroni test is used for Mutual comparison between two groups of measurement data;chi-square test is used for binary classification data;Dunnett T3 test was used for measurement data;regression analysis was used for correlation between measurement data;ROC curve was drawn to evaluate the role of influencing factors in prediction.P<0.05 was considered statistically significant.Results229 women examed by CAG in the First Affiliated Hospital of Zhengda University were enrolled,of which 60 had three-vessel disease,73 had non-three-vessel disease,and 96 had no coronary disease.1 The prevalence of hypertension and type-2 diabetes of three-vessel group is highest,while that of healthy control group is lower than in the three-vessel group and the non-three-vessel group.Coronary occlusion was both found in three-vessel group and non-three-vessel group.The number of individuals with single-vessel occlusion was 17 in three-vessel group and 14 in non-three-vessel group respectively.There were 4 with two-vessel occlusion in the three-vessel group,and one with three-vessel occlusion.(P<0.05)2 Omentin and adiponectin levels were the lowest in the three-vessel group.There was no statistical difference in LDL-C levels between three-vessel group and non-three-vessel group,but both were higher than that of the healthy control group.The HDL-C level in healthy control group was lower than that in three-vessel group and non-three-vessel group,but no significant difference between the latter two groups.There was no statistically significant difference in HbAlc levels between three-vessel group and non-three-vessel group,but both were higher than that of healthy control group.(P<0.05)3 There was a linear positive correlation between omentin(47.34±10.38)and adiponectin(4.14±1.37)in the study population(R2=0.123).The level of omentin(39.57±7.17)and Gensini score(5 1.45±33.01)in three-vessel group showed a linear negative correlation(R2=0.532).The adiponectin level(3.58± 1.30)in the three-vessel group was negatively and curvilinearly correlated with the Gensini score(51.45± 33.01)(R2=0.412).(P<0.05)4 When the omentin cutoff value was set at 39.82ng/mL,the sensitivity of diagnosing diabetes was 80.2%,and the specificity was 52.8%.When the omentin cutoff value was set to 39.69ng/mL,the sensitivity of judging the three lesions was 78.1%,and the specificity was 51.3%.ConclusionsOmentin and adiponectin are related to Gensini in patients with coronary artery disease,and the level of adiponectin itself has an effect on the level of omentin.The effect of LDL is consistent with previous studies.Hypertension and diabetes continue to maintain the status of classic coronary heart disease risk factors.Although the degree of coronary artery disease can be affected by many factors,omentin may still be a predictor and evaluation index of coronary artery disease in the future.