Relationship Between Metabolic Syndrome And Coronary Heart Disease

BackgroundMetabolic syndrome is a group of clinical syndrome which determined by genetic factors and environmental factors , including abnormal metabolism of glucose and insulin, obesity (especially abdominal obesity), hyperlipidemia and hypertension. These clinical symptoms are almost the important risk factors for coronary heart disease, so the relationship between metabolic syndrome and coronary heart disease is being concerned about.In patients with coronary heart disease, acute coronary syndrome more easily induced cardiovascular events.Numerous studies show that , atherosclerotic plaques become instable and rupture occurred ,which is following by secondary acute thrombosis, it is the main reason for acute coronary syndrome.Therefore factors affecting the stability of atherosclerotic plaques in recent years has aroused people's concern. Now a lot of experimental studies found that ,in the patients with acute coronary syndrome, inflammation is more active and the activity of matrix metalloproteinases (MMPs) is much higher around the plaque tissue, the degradation of collagen fibers in the fibrous cap is strengthened, and the fibrous cap becomes thinner and thinner, while external trigger factors occur, the plaque rupture following by secondary acute thrombosis ,as a result,acute coronary syndrome is evoked.Whereas,there are less reports about whether metabolic syndrome would affect the stability of the atherosclerotic plaque or not.Disorder of lipid metabolism has long been recognized as an independent risk factor for coronary heart disease, and at present many studies have shown that,The predictive value of apolipoprotein for coronary heart disease is Superior than the conventional liposomes, apolipoprotein A1 (ApoA1) and apolipoprotein B (ApoB) are the important indicators. And the researches about the relationship between apolipoprotein metabolism disorders and metabolic syndrome are also being examined.This study inquires the impact on the the formation and stability of plaque caused by metabolic syndrome through the comparison between the metabolic syndrome crowd and non-metabolic syndrome crowd, inquiring of the metabolic syndrome atherosclerotic of the impact,at the same time, the relationship between MMPS and acute coronary syndrome ,also the predictive value of ApoA1,ApoB for coronary heart disease research. Are investigated.MethodsChoose the 270 objects who were examined in the department of cardiovasology in Second Hospital of Jilin University from March 2007 to February 2008 ,due to chest pain or other symptoms and suspected of suffering from coronary heart disease ,all underwent coronary angiography,having integrited clinical data . All the patients exclude liver and kidney disease, thyroid disease, blood disorders, autoimmune disease, cancer, cerebrovascular accidents and peripheral embolic disease.All the patients are divided into metabolic syndrome crowd and non-metabolic syndrome crowd, based on the body mass index, blood sugar, blood pressure, serum lipids. According to patients'medical history, electrocardiogram, cardiac markers, coronary angiography ,they are also divided into non-coronary heart disease group, stable angina group and acute coronary syndrome group. The level of MMP-2, Apo-A1, Apo-B in serum.of every patient were measured accurately,Using SPSS software for data processing, t-test andχ2 test.ResultsIn all the 270 patients, according to the diagnostic criteria of metabolic syndrome (MS) of Chinese Medical Association diabetes branch ,165 cases are diagnosed as non- metabolic syndrome, while 105 cases are diagnosed as metabolic syndrome. According to the standard for diagnosing coronary artery disease , in the non- metabolic syndrome group, 80 cases are diagnosed as without coronary heart disease, 85 cases are diagnosed as suffering from coronary heart disease , including 40 cases of stable angina , 45 cases of acute coronary syndrome; At the same time,in the metabolic syndrome group, 16 cases are diagnosed as without coronary heart disease, 89 cases are diagnosed as suffering from coronary heart disease , including 25 cases of stable angina , 64 cases of acute coronary syndrome.In the non-MS group, the incidence of coronary heart disease is 51.5%, the ratio of acute coronary syndrome in all the patients with coronary heart disease is 52.9%; In the MS group, the incidence of coronary heart disease is 84.8%, the ratio of acute coronary syndrome in all the patients with coronary heart disease is 71.9%. Compared with non-MS group, the incidence of coronary heart disease in MS group significantly increased (P <0.05), and the ratio of acute coronary syndrome in all the patients with coronary heart disease significantly increased (P <0.05). Whether in the metabolic syndrome crowd or non-metabolic syndrome crowd, there was no significant difference between the levels of MMP-2 in stable angina patients and non-CHD group (P> 0.05), the levels of MMP-2 in acute coronary syndrome Group were significantly higher than those without coronary artery disease group (P <0.05), also increased significantly comparing with those of stable angina pectoris group (P <0.05).The levels of Apo-A1, Apo-B, Apo-B/Apo-A1 in coronary heart disease group has the statistical significance while comparing with those of non-coronary heart disease group (P <0.05), and the levels of Apo-A1, Apo-B, Apo-B/Apo-A1 in metabolic syndrome group who are combined with coronary heart disease have statistical significance while they are compared with those of who have coronary heart disease in non-MS group (P <0.05).conclusion1,Comparing with those of non-metabolic syndrome crowd , the incidence of coronary heart disease in metabolic syndrome crowd significantly increased, the process of coronary atherosclerotic plaque formation. is promoted by metabolic syndrome. 2,Compared with the patients with coronary heart disease in non-metabolic syndrome crowd, atherosclerotic plaque become more unstable in the patients who are suffered from coronary heart disease in non-metabolic syndrome crowd.The low systemic inflammatory state of metabolic syndrome itself may participate the progress of atherosclerotic plaque rupture. 3,MMPs is further confirmed as an predictive indicator of the stability the of coronary artery atherosclerotic plaque ,while the atherosclerotic plaque become unstable, the levels of MMP-2 were significantly increased. 4,Both in people with metabolic syndrome or non-metabolic syndrome crowd, ApoA1, ApoB, ApoB/ApoA1 are significant predictive indicator of coronary heart disease , and the changes of those indicators in metabolic syndrome population are more prominent.