Study On The Correlation Between Serum C1q Tumor Necrosis Factor-related Protein 4(CTRP4)and High-sensitivity C-reactive Protein Levels And Coronary Heart Disease

Objective:To explore the relationship between serum C1 q tumor necrosis factor-related protein 4(CTRP4)and high-sensitivity C-reactive protein(hs-CRP)levels and coronary heart disease(CHD)and its clinical value.Method:1.Select patients who attended the Department of Cardiovascular Medicine of the Hospital from April 2019 to April 2020 and received coronary angiography as the research objects.The results of coronary angiography confirm the clinical diagnosis of coronary heart disease(angiography)Results The degree of stenosis of at least one coronary artery was ≥50%),the number of coronary artery diseased branches was counted according to the angiographic results,and the Gennisi score was used to evaluate the severity of coronary artery disease.According to the results of the angiography and the presence or absence of diabetes,62 cases were in the CHD group,66 cases were in the coronary heart disease combined with diabetes(DM+CHD)group,and 126 cases were selected as the control group.2.Collect the general clinical data of the research subjects,including age,gender,weight,height,systolic blood pressure,diastolic blood pressure,drinking history,etc.,collect the subjects’ fasting right upper limb venous blood at 6 am for biochemical analysis,and count the subjects on fasting Fasting blood-glucose(FBG),hs-CRP and other biochemical indicators,the enzyme-linked immunosorbent assay(Elisa method)was used to determine the serum CTRP4 level of subjects,and the scattering turbidimetric method was used to determine the hs-CRP level.3.All data were analyzed and processed using IBMSPSS25.0 statistical software.Serum comparison parameters of each group were represented by(±),using single-factor variance and q-test analysis,comparison between pairs was performed by LSD-t test,and Pearson was used for correlation between data Analysis,the use of receiver operator characteristic curve(Receiver operator characteristic curve,ROC curve)to evaluate the actual clinical application value,P <0.05 as the difference is statistically significant.Results:1.Among the 254 patients enrolled,62 were in the simple coronary heart disease group,66 were coronary heart disease combined with diabetes,and 126 were in the control group.The results of a one-way analysis of variance showed that there was no difference in age,gender,body mass index(BMI),systolic blood pressure,diastolic blood pressure,and alcohol drinking history in the simple coronary heart disease group,the coronary heart disease combined with diabetes group and the control group.Statistically significant(P>0.05).2.Analysis of serum CTRP4 and hs-CRP levels in each group showed that the coronary heart disease combined with diabetes group was significantly higher than the simple coronary heart disease group and the control group(P﹤0.05),and the simple coronary heart disease group was significantly higher than the control group(P ﹤0.05)),the difference is statistically significant(P﹤0.05).3.According to the results of coronary angiography,all the subjects were divided into three groups,including 29 cases in the single-vessel disease group,42 cases in the double-vessel disease group,and 57 cases in the three-vessel disease group.The single-factor analysis of variance showed that the coronary arteries in the experimental group The levels of CTRP4 and hs-CRP in the three-vessel disease group were higher than those in the two-vessel disease and single-vessel disease group(P﹤0.05),and the two-vessel disease group was higher than the single-vessel disease group(P﹤0.05).The difference was statistically significant(P﹤ 0.05).4.Pearson correlation analysis was used to analyze the number of coronary artery lesions and the serum CTRP4 and hs-CRP levels in the experimental group.The results showed that there was a significant difference between the CTRP4,hs-CRP levels and Gennisi scores in the simple coronary heart disease group and the coronary heart disease combined with diabetes group Positive correlation,and the correlation between Gennisi score and CTRP4 level and hs-CRP level in coronary heart disease combined with diabetes is higher than that between Gennisi score and CTRP4 level and hs-CRP level in simple coronary heart disease group.5.ROC curve analysis shows that serum CTRP4 and hs-CRP levels predict the AUC of pure coronary heart disease to be 0.940 and 0.934,respectively,which have a high reference value.The maximum cut-off point of the Yorden index on the upper left of the ROC curve is the best cut-off value(CTRP4 is 0.60,hs-CRP is 0.97),the prediction sensitivity and specificity of this point: CTRP4 is 85%,87%,hs-CRP is94%,90%,which has certain predictive value.Incorporate CTRP4 and hs-CRP into the Logistic regression model,obtain the numerical calculation formula of the binomial combination through regression coefficients,and obtain the combined data from statistical analysis.Further ROC curve shows that the binomial combination predicts AUC of 0.961,sensitivity 97%,and specificity The degree of 91% is higher than that of single item detection,indicating that the value of joint prediction is higher.6.ROC curve analysis shows that serum CTRP4 and hs-CRP levels predict the AUC of coronary heart disease complicated with diabetes to be 0.980 and 0.964,respectively,which has a high reference value.The maximum cut point of the ROC curve on the upper left of the Youden index is the best Critical value(0.78 for CTRP4,0.98 for hs-CRP),the predictive sensitivity and specificity of this point: 95% and 89%for CTRP4,85% and 77% for hs-CRP,which have certain predictive value.Incorporate CTRP4 and hs-CRP into the Logistic regression model,and obtain the numerical calculation formula of the binomial combination through regression coefficients.Statistical analysis to obtain the combined data.Further ROC curve shows that the binomial combined prediction AUC is 0.982 with a sensitivity of 98%and a specificity of 87 %,the sensitivity is higher than that of a single test,indicating that the value of joint prediction is higher.Conclusion:1.Serum CTRP4 and hs-CRP levels are positively correlated with the severity of coronary heart disease,and the correlation is more obvious in coronary heart disease and diabetes,suggesting that CTRP4 and hs-CRP play an important role in glucose and lipid metabolism.2.There was a significant positive correlation between serum CTRP4 and hs-CRP levels in the experimental group and Gennisi score,and the correlation between Gennisi score and CTRP4 levels and hs-CRP levels in the DM+CHD group was higher than that in the CHD group,suggesting that serum CTRP4 and hs levels-Elevated CRP levels may indicate an increase in the severity of coronary artery disease.It can be used clinically for the identification and early prevention of coronary heart disease,and has certain clinical reference value.