The Sex Difference Of Lipids In Patients With Coronary Heart Disease

Objective: To investigate the lipids in patients with coronary heart disease,and determine the severity of the coronary artery stenosis with Gensini standard. Our aim is to find the sex difference of lipids in patients with coronary heart disease,and sex difference of the relationsh.ip between lipids and the severity of the coronary artery stenosis.Method: A total of 1435 patients (men 1098, women 337)were selected from August 1999 to July 2006.The inclusion criteria include as the followings :the patients who were performed coronary angiography for the first time.The criteria for exclusion include as the followings :previously diagnosed as familial hyperlipoidemia,acute coronarial events, valvular disease and data incompleted.The coronary angiography were evaluated by experienced cardiologists.The degree of luminal narrowing was recorded in percentage of prestenotic diameter.The patients with coronary artery internal luminal narrowing of >50% were diagnosed coronary heart disease.According to Gensini standard,to evaluate the severity of the coronary artery stenosis.coronary artery internal luminal narrowing of≤25%,the score is 1;≤50%,the score is 2;≤75%,the score is 4;≤90%,the score is 8,≤99%,the score is 16;100%,the score is 32.The ultimate score of every subject is summation of the scores of total coronary artery branch. According the results of the coronary angiography,the total subjects were divided four groups: male CHD group,male compare group,female CHD group,female compare group.The total subjects were measured lipids,blood pressure,fasting glucose.The methods of measure lipids:measure total cholesterol (TC)with CHOD-PAP,triglyceride(TG)with GPO-PAP,LDL cholestero(lLDL-C)with Friedewald formula, HDL cholesterol (HDL-C) with phosphoric acid wolfram magnesium-preciptitation method. Fasting glucose was measured with glucose oxidase-superoxide enzymic method.The method of measuring blood pressure was : record the blood pressures in three different morning, then compute the mean value .Age , weight were also measured. Statistical analysis was performed using SPSS 13.0 statistics software. Significance test of enumeration data was performed byχ2 test. Significance test of measurement data was performed by t test. The analysis of relationship between risk factors and the score of coronary artery stenosis was performed by Spearman,s rank correlation analysis.The parameter which have significance in Spearman,s rank correlation analysis were performed by multiple regression analysis. P<0.05 was considered statistically significant .Result: According to the results of coronary angiography, patients were divided into four groups : male CHD group ,male compare group,female CHD group ,female compare group. The results of age ,weight, SBP,DBP, fasting blood glucose, TC(5.49±3.05 ,4.32±1.03)LDL-C(3.49±0.98, 2.40±0.96 ) were statistically different between the male CHD group and male compare group (p<0.05). The results of age , SBP, DBP, fasting blood glucose, TC (5.49±3.05, 4.32±1.03 ) HDL-C (1.48±0.42 , 1.57±0.40 ) were statistically different between the female CHD group and female compare group (p<0.05). In Spearman,s rank correlation analysis , there were statistically significant between the score coronary artery stenosis and age ,SBP, fasting glucose, LDL-C, APOB, HDL-C, APOA, (rs=0.212,0.072,0.129,0.181,0.083,-0.078,-0.107) in male CHD group . In Spearman,s rank correlation analysis ,there were statistically significant between the score of coronary artery stenosis and age , SBP, DBP , TC, LDL-C,fastingglucose, (rs=0.150, 0.203, 0.155,0.233, 0.2490, 0.190) in female CHD group.In multiple regression analysis, there were positive correlativity between age, APOB and the score of coronary artery stenosis in male CHD group (p<0.05) .there were negative correlativity between APOA and the score of coronary artery stenosis in male CHD group (p<0.05). there were positive Correlativity between age and the score of coronary artery stenosis in female CHD group (p<0.05).Conclusion:Our study showed that TG and HDL-C are very important risk factors in female CHD patients. During the treatment of the female CHD patients , LDL-C should be cut down actively at the same time HDL-C and TG should be pay attention to. The sex difference should been attached importance to during the treatment of lipids abnormality with CHD.