A Study On The Association Of Sex Hormones With Coronary Heart Disease And Its Severity Of Stenosis In Men

Objective: The pathogenesis of coronary heart disease(CHD)is not totally known.The morbidity of CHD is differentgreatly from gender and that of male is recognized as adependent risk factor for CHD.The previous studies and clinicaldata suggest it is possible that there are some connectionsbetween sex hormone internal environment and the incidence ofCHD ,yet the research of them has not been confirmed.Theobjective of this study is to explore the relationship between thedisturbance of sex hormone internal environment and CHD andits severity of coronary artery stenosis in male.Methods: The study enrolled 115 male patients whoreceived coronary angiography in Center of CardiovascularDisease of the First Hospital of Hebei Medical University fromSeptember 2003 to November 2004.Clinical baselineinformation were recorded in detail,including age,height,weight,history of smoking,hypertension,diabetes and drug takenhistory.Venous blood samples were taken and stored in lowtemperature refrigerator for examination on the first morningafter admission. Then the concentrations of sex hormones, Hcy,ET-1 and biochemistry were determined.The Judikins selectivecoronary angiography was taken,then the degrees of coronaryarterial stenosis were qualitatively evaluated.According to theresults of coronary angiography,75 subjects whose involvedcoronary artery diameter's loss was more than or equal to 50percent were assigned to CHD group and other 40 subjectswhose involved coronary artery diameter's loss was less than 50percent were assigned to control group.The subjects of CHDgroup were subdivided into three subgroups including singlebranch group,couple branches group and multiple branchesgroup according to the number of coronary lesion.Statistical analysis:1.SPSS 12.0 software pack was used tomake statistical analysis.(1)Chi-square (x~2) test,student's ttest,one-way-ANOVA,partial correlation analysis,multiple linerregression and Logistic regression analysis were used in thestudy.(2)All the enumeration data was compared by x~2 test.(3)All the measurement data was denoted by mean±standarddeviation.Comparison between two groups: student's t test wasused when the data were normal distribution andhomoscedasticity,student's t'test was used when the data werenormal distribution and non-homoscedasticity and when the datawere not normal distribution, student's t test was used afterlogarithmic transformation.One-way-ANOVA was used todenote the correlation among multiple groups and LSD wasused when the difference was significant. 2.The steps ofstatistical analysis: (1)The general clinical data between theCHD group and the control group was analyzed using x2 testand student's t(or t')test(size of a test α=0.05). (2)Therelationship between sex hormones'level and CHD wasanalyzed. ①The indexes of the sex hormones between the CHDgroup and the control group was compared using student's t(ort')test(size of a test α=0.05). ②Taking the branch numbers ofcoronary stenosis and the Gensini's score for the severity ofcoronary stenosis,the relationship between the levels of sexhormones and the severity of coronary stenosis was analyzed.Firstly,one-way-ANOVA was used to denote the relationshipbetween the sex hormones and branch numbers of pathologiccoronary arteries.When the difference was significant,LSD wasused(size of a test α=0.05).Secondly,multiple liner regressionwas used to analyze the correlation between the multivariate andthe Gensini's score in the CHD group (test levelα1=0.05, α2=0.10). ③With the occurrence of CHD as the dependent variableand the multivariate as the independent variables and selectingthe significant independent variables by likelihood ratio test,multiple Logistic regression was used to investigate whether theabnormal of sex hormones was a dependent risk factor for CHDin men. (3)The relationship between the sex hormones and theestablished risk factors for CHD was analyzed. ①The CHDgroup and the control group were all divided into two subgroupsbased on the history of cigarette smoking,Hypertension anddiabetes,then the sex hormones between the subgroups werecompared by student's t(or t')test(size of a test α=0.05). ②Partial correlation analysis was used to analyze the correlationamong the levels of sex hormones and the measurementvariables of the established risk factors for CHD in men (size ofa test α=0.05).Results: 1.Clinical baseline characteristics of the subjects:There was no difference between the two groups about age,SBP,DBP, TG, HDL-C, apoA, apoB, apoA/B, Glu, UA, ET-1 and theincidence of hypertension and diabetes(size of a test α=0.05).The percentage of smoking history (x2=4.079,P=0.043),the value of TC(t'=4.642,P=0.001),LDL-C(t'=4.220,P=0.000)and Hcy(t'=2.522,P=0.013) in the CHD group were higher thanthe control group and the differences were all significant(size ofa test α=0.05).2.The relationship between sex hormones andCHD. (1)There was no difference between the two groups aboutE2,P and E2/T.The value of T(t'=3.642,P=0.001),DHEA(t'=3.895 ,P=0.000) and DHEAS(t=2.687,P=0.029) in the controlgroup were lower than the CHD group and the differences wereall significant(size of a test α=0.05). (2)The relationshipbetween sex hormones and the seriousness of coronary arterystenosis. ①Relationship between the sex hormones and thenumber of diseased coronary artery: There was no differenceamong the control group and the three subgroups of CHD groupabout E2,P and E2/T. The value of T(F=11.281,P=0.000), DHEA(F=11.104,P=0.000)and DHEAS(F=3.102, P=0.031)correlatedwith involved branch numbers negatively. ②Relationshipbetween the sex hormones and Gensini's score: Multiple linerregression showed that DHEA,DHEAS,age,the history ofdiabetes,BMI,TC and LDL-C were applied to the optimumregression equation.Bias regression coefficients were -0.229,-0.230,0.189,0.265,0.185,0.292 and 0.199 individually.3.Relationship between the sex hormones and the establishedrisk factors for CHD in males: (1)Control group:The value of Twas lower in the hypertension subgroup (P<0.01). (2)CHDgroup:The value of E2 was higher in the diabetes subgroup.Thevalues of T and DHEA were all lower in the hypertension...