| Objectives:To analyze the distribution of serum lipids level in patients with or without coronary heart disease (CHD). Try to compare the relationship between serum lipids and CHD, to evaluate the predicative value of serum lipids and lipid ratios for CHD and the severity of coronary artery stenosisMethods:Eight hundred and ninety-eight subjects, who underwent coronary angiography (CAG) were classified into CHD group (n=660) and non-CHD group (n=235) according to the CAG result. Clinical data and serum lipid levels were obtained from all the eligible cases. The severity of coronary artery stenosis was assessed by the numbers of involved coronary artery branches and the sum of the respective Gensini scores.Results:The levels of serum lipids were significantly different between patients with CHD and non-CHD. CHD patients tend to have lower serum HDL-C (P<0.01) and Apo-AI (P<0.05) levels, and also have the higher serum levels of remaining lipids parameters than non-CHD subjects. The ratios of serum lipids, including Apo-B/Apo-AI, TG/HDL-C, LDL-C/HDL-C, Lp(a)/HDL-C, Lp(a)/Apo-AI and Non-HDL/HDL-C, were significantly different between CHD patients and controls. The LDL-C/HDL-C ratio was significantly higher in patients with Multi-vessel lesions [[2.94±0.89]] than those with single vessel lesion [[2.74±1.05], p< 0.05] and those with non-lesions [[2.45±0.89], p<0.05]. All the lipid ratios were positively correlated with the Gensini scores, which includ Non-HDL/HDL-C (r=0.163, P< 0.01), TG/HDL-C (r=0.166, P<0.01), LDL-C/HDL-C (r=0.209, P <0.01), Lp (a)/HDL-C (r=0.165, P<0.01) and Lp(a)/Apo-AI (r= 0.135,P< 0.01). The lipid ratios resulted in greater correlation coefficients to Gensini score than their separate existence did. Logistic regression analysis showed that serum TG/HDL-C (OR=1.433,P=0.000) and Lp(a)/Apo-AI (OR=1.462,P=0.016) ratios were independently associated with CHD. Multiple linear regression analysis showed that serum TG/HDL-C(p=0.006) and LDL-C/HDL-C(p=0.001) levels were independently associated with Gensini scores.In subjects with TG> 150mg/dl (1.7mmol/L), there is no significant difference in LDL-C between CHD and Non-CHD groups (p=0.057) although LDL-C is statistically positive correlated with Gensini scores (R =0.159,P<0.01). Significant differences in TG/HDL-C (P<0.01), LDL-C/HDL-C (P<0.05), and Lp(a)/Apo-AI (P<0.01) ratio were seen between CHD patients and controls. All the lipid ratios have greater correlation coefficients to Gensini score than their separate existence did. Logistic regression analysis and Multiple linear regression analysis showed that TG/HDL-C (OR=3.059, P=0.001) and Lp(a)/Apo-AI (OR=1.912, P=0.001) were independently associated with CHD. TG/HDL-C(P=0.047) and LDL-C/HDL-C(P=0.024) independently associated with G scores.In subjects with serum LDL-C<100mg/dl (2.6mmol/L), LDL-C had no longer significant difference between CHD and Non-CHD groups and it had no correlation with Gensini scores, while TG/HDL-C (P<0.01), LDL-C/HDL-C (P<0.05), and Lp(a)/Apo-AI P<0.05) ratios were still significantly different between CHD patients and controls. They yield in greater correlation coefficients to Gensini score, such as LDL-C/HDL-C (R=0.160,P<0.01); TG/HDL-C(R=0.150,P<0.01); Lp(a)/Apo-AI (R=0.116,P<0.05). Logistic regression analysis and Multiple linear regression analysis showed that TG/HDL-C was the sole independent lipid parameter contributing to CHD risk (OR=1.809,P=0.001) and G scores (P=0.001).Conclusions1. The lipids ratios (ratio of arteriosclerosis lipids with anti-atherogenic lipids) tend to have greater impact on risk of CHD.2. Serum TG/HDL-C, LDL-C/HDL-C and Lp(a)/Apo-AI are independently associated with CHD and G scorses, indicating lipid ratios are better than lipid alone in assessing risk and severity of coronary artery stenosis.3. TG/HDL-C demonstrated unique value in differentiating CHD risk and the severity of coronary artery stenosis in subjects with hight TG level(>1.7mmol/L) or normal LDL-C(<2.6mmol/L).
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