| Background:Coronary atherosclerotic heart disease(CAD) is a common disease and one of principal causes of illness and death. The morbility and mortality of CAD are increasing year by year. CAD is a disease determined by genetic factor and environmental agents. The etiopathogenisis and pathogenesis of CAD are very complicated. The pathology basis of CAD is artherosclerosis(AS), is a chronic inflammation disease of endothelium,characteristiced by the formation of AS plaque. Some studies indicate that the foam cell formation in human monocyte-derived macrophages plays an extraordinarily important role in the pathogenesis of coronary atherosclerosis. Salusins are two newly discovered cardiovascular bioactive peptides consisting of 28 and 20 amino acids and designated salusin-αlpha and salusin-beta. Salusins are translated from an alternatively spliced mRNA of TOR2A, a gene encoding a protein of the torsion dystonia family. Intravenous administration of salusins to rats causes rapid, profound hypotension and bradycardia.salusins increase intracellular Ca2+, upregulate a variety of genes and induce cell mitogenesis. Salusin-βstimulates the release of arginine vasopressin from rat pituitary. Salusin-αand salusin-βare detected in many human tissues, plasma and urine. Preliminary study also indicates that salusin-αexerts a significant anti-atherosclerotic effect via suppression of foam cell formation from monocyte-derived macrophages by down-regulating acyl-CoA and cholesterolacyltransferase-1. However, the association of the salusin-αlevel with the severity and stability of coronary atherosclerosis in CAD patients remains to be established.Objective:To see whether salusin-αlevel correlates with stability and severity of coronary atherosclerosis and other established cardiovascular risk factors.Methods:Patients group: we studied 122 hospitalized patients with coronary artery disease (CAD) who were diagnosed by coronary angiography (CAG) in cardiovascular department of changhai hospital from October 2008 to January 2009. The severity of pathological changes of the coronary artery was assessed by the number of diseased coronary branches and Gensini's score. The CAD patients were further divided into subgroups according to the clinical types, the number of diseased coronary branches and Gensini's score.The patients were devided into stable angina pectoris (SAP,n=48) and acute coronary syndrome (ACS,n=74) according to the clinical types; were devided into one-vessel(n=45),two-vessel(n=46) or three-vessel disease(n=31) on the basis of the number of diseased coronary branches and were devided into 0 to 20 score(n=61), 20 to 40 score(n=27) or above 40 score(n=34) according to the Gensini'score. Control group: we selected 60 healthy subjects matched for the age with the patients group. Salusin-αlevel, white blood cell (WBC) count, lipids(TC, TG, LDL-C, HDL-C), fasting plasma glucose(FPG), blood pressure(SBP, DBP) and body mass index(BMI) were measured, and age, sex and prior medical histories including hypertension, diabetes mellitus and smoking status were obtained before CAG in all subjects. Clinical parameters and biochemical indicators were compared statistically between the subgroups, and correlation coefficient of salusin-αlevel with the number of diseased coronary branches and Gensini's score, and other conventional risk factors for CAD was calculated. Categorical variables are expressed as percentage of patients; continuous mormal distribution variables are expressed as mean values±SD( x±s); Skewed distribution variables are expressed as median values(25th/75th quartiles) , Differences between continuous variables of two groups were tested for statistical significance by means of t test. Differences among three or more groups were tested by means of covariance analysis. The association of continuous variables with the extent of CAD was tested by Pearson one-way analysis of variance. We assessed associations among variables with use of Pearson's correlation coefficient. P<0.05 was considered statistically significant.Results:1) Peripheral blood salusin-αlevel in CAD patients was significantly lower than that in controls(0.50±0.18 ng/ml vs 0.69±0.23 ng/ml P<0.01). 2) Peripheral blood salusin-αlevel in ACS patients was significantly lower than that in SAP patients(0.46±0.17 ng/ml vs 0.56±0.19 ng/ml,P<0.01).Salusin-αlevel was not correlated with the number of diseased coronary branches, it's level in one-vessel, two-vessel and three-vessel disease group was 0.49±0.18 ng/ml , 0.50±0.19 ng/ml and 0.51±0.19 ng/ml respectively (P>0.05). Salusin-αlevel was not correlated with Gensini'score, it's level in 0 to 20 score, 20 to 40 score and above 40 score group was 0.51±0.20 ng/ml, 0.49±0.14 ng/ml and 0.49±0.19 ng/ml respectively(P>0.05). 3) Salusin-αlevel was negatively correlated with TC (r=-0.2193,P <0.05),TG (r=-0.2024, P <0.05), LDL-C (r=-0.2760,P <0.01) and HDL-C (r=-0.3124, P<0.01) respectively,and not correlated with BMI,age,smoking, Hypertension,DM status,SBP,DBP,TG,WBC and FPG.Conclusion: Peripheral blood salusin-αlevel is significantly lower in CAD patients than that in controls. Peripheral blood salusin-αlevel in ACS patients was significantly lower than that in SAP patients, it is suggested that blood salusin-αlevel is associated with stability of the coronary artery disease. Salusin-αlevel is not correlated with the number of diseased coronary branches and Gensini's score, indicating that it is not relevant to the severity of coronary atherosclerosis. Salusin-αlevel is negatively correlated with TC ,TG,LDL-C and HDL-C, and not correlated with BMI,age,smoking, Hypertension,DM status,SBP,DBP,TG,WBC and FPG, indicating that it is independently relevant to the pathogenesis of coronary atherosclerosis. |
PDF Full Text Request