| Objective To investigate the relationship between degree of coronary artery disease (CHD) and high-sensitiviy C-reactive protein(hs-CRP),free fatty acids(FFA),adiponectin (APN) in patients with coronary heart disease,through detecting the concentration of hs-CRP,FFA,APN.Methods Patients in our hospital during October 2008 to July 2009 and healthy Chinese volunteers were recruited.There were three parts in our research.The first part:comparative analysis between CHD group and healthy control group.All selected subjects(172 cases) were divided into two groups:1.CHDgroup:A total of 112 cases(94 males and 18 females,the average age was 61.027±11.307 years) were divided into two subgroups according to the clinical characteristics of patients:acute coronary syndrome(CHD-ACS) subgroup:59 patients(48 males and 11 females,the average age was 61.119±10.810 years);stable angina pectoris(CHD-SAP) subgroup: 53 patients(46 males and 7 females,the average age was 60.925±11.940 years);2.60 sex-and age-matched healthy Chinese volunteers were recruited as normal controls (44males and 16females,the average age was 57.467±12.963 years) and confirmed do not have hypertension,cerebrovascular disease,diabetes,etc.The second part:The CHD group was divided into CHD-MS group and CHD-nMS group according to whether coronary heart disease is complicated with metabolic syndrome.CHD-MS group:59 patients(47 males and 12 females,the average age was 9.441±11.187 years);CHD-nMS group:53 patients(47 males and 6 females,the average age was 62.793±11.284 years),comparatively analyse the difference of 3 indicators between the two groups.The third part:all the patients in CHD group were divided according to coronary angiography based on number of disease:single-vessel disease(CHD-M), double vessel disease(CHD-D),triple vessel disease(CHD-T) group.CHD-M group: 44 patients(40 males and 4 females,the average age was 60.500±11.997 years); CHD-D group:32 patients(25 males and 7 females,the average age was 61.969±11.533 years);CHD-Tgroup:36 patients(29 males and 7 females,the average age was 60.833±10.473 years).The concentration of hs-CRP,FFA and APN in serum were measured by Enzyme linked immunosorbent essay(ELISA).The correlation of coronary artery score(CAS) and hs-CRP,FFA,APN were analyzed.ResultsComparasion between CHD group and control group:1 The concentration of hs-CRP,FFA in CHD group was significantly higher,but concentration of APN was significantly lower than the control group,the difference between the two groups was statistically significant.2 Comparasion between CHD-SAP group and CHD-ACS group:the concentration of hs-CRP and FFA in CHD-ACS group was significantly higher,but the concentration of APN was significantly lower.The difference between the two groups was statistically significant.3 Comparasion between CHD-SAP group and control group:the concentration of FFA in CHD-SAP group was significantly higher,and the difference between the two groups was statistically significant.The concentration of hsCRP,APN in SAP group compared with the control group,there is no significant difference between the two groups.4 Correlation analysis about APN,FFA and Body mass indicator:the serum APN levels of all objects was negatively correlated with waist circumference,body mass index,waist-hip-ratio,the difference was statistically significant(r=-0.179～0.234,P＜0.05).There was no significant correlation between APN and hip circumference, waist-high-ratio.The FFA levels of all objects was negatively correlated with hip circumference,body mass index,waist-hip-ratio,waist-high-ratio the difference was statistically significant(r=0.178～0.258,P＜0.05).There was no significant correlation between FFA and hip circumference. 5 Pearson correlation analysis between CHD-CAS and other index:Waist circumference, body mass index,systolic blood pressure,pulse pressure,pulse pressure index, mean arterial pressure,total cholesterol,high density lipoprotein,hs-CRP,APN,FFA are associated with the CAS.CAS-related indicators as independent variables in single-factor analysis,CAS as the dependent variable in a regression analysis showed that FFA and pulse pressure remained associated with the CAS.There were no significant relationships between CAS and other body indexes(hip circumference,waist-high -ratio,waist-hip-ratio,triglyceride,low-density lipoprotein).Comparasion between CHD-MS group and CHD-nMS group:Compared with the CHD-nMS group concentration of hs-CRP and FFA in CHD-MS group was significantly higher,but the concentration of APN was significantly lower, the difference of 3 indicators between the two groups were statistically significant.Pairwise comparison between CHD-M,CHD-D,and CHD-T groups:The concentration of hs-CRP and FFA in CHD-D group was significantly higher than CHD-M group,but significantly lower than CHD-T group.The pairwise comparison of hs-CRP were statistically significant(t=-4.863～-2.121,P=0.000～0.041).The pairwise comparison of FFA were also statistically significant(t=-5.074～-2.078, P=0.000～0.042).The concentration of APN decreased with the increase of the number of diseased vessels,and there were statistically significant difference between any two groups.(t=2.080～3.885,P=0.000～0.042).Pearson correlation analysis between the concentrations of hs-CRP,APN and FFA:The concentrations of APN was negatively correlated with the concentration of hs-CRP(r=-0.223,P=0.018),but there was no significant correlation with FFA; concentration of hs-CRP was positively correlated with FFA(r=0.280,P=0.003).Conclusions1 There were correlation between hs-CRP,FFA,APN and coronary heart disease. APN is a protective factor in coronary heart disease,but hs-CRP,FFA on atherosclerosis and coronary artery disease may play a catalytic role.2 There were some value that hs-CRP,FFA,and APN may determine whether the coronary atherosclerotic plaque stable.Hs-CRP,FFA may be able to promote the increase of coronary atherosclerotic plaque instability,ACS occur in clinic;APN may be able to promote stability of atherosclerotic plaques,reduce the incidence of ACS. 3 Inflammatory response was even more active,lipid metabolism disorders even more prominent in CHD patients Combined MS.
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