The Study On Plasminogen Activator Inhibitor Type 1 And High-sensitive C-reactive Protein In Metabolic Syndrome With Coronary Heart Disease

Objective To investigate the relationship with the levels of plasminogen activator inhibitor type 1,high-sensitive C-reactive protein and metabolic syndrome,the severity of coronary artery pathological changes.Methods 120 subjets with metabolic syndrome, according to diagnostic criteria suggested by the International Diabetes Federation in 2005, were divided into two groups:one group was pure MS which consisted of 60 patients and the other group was MS with CHD which consisted of 60 patients.40 health people at the same stage, whose age and gender were similar with those in MS group served as normal control group. we collected the subjects' common datas and measurede of the levels of body mass index(BMI),waist circumference(WC),systolic blood presser(SBP),diastolic blood presser(DBP),triglyceride(TG),total cholesterol(TC),high density lipoprotein cholesterol(HDL-C), fasting blood glucose(FBG),plasminogen activator inhibitor type 1 (PAI-1),high-sensitive C-reactive protein(hs-CRP) in three groups. The plasma PAI-1 concentration was assayed by enzyme-linked immunosorbent assay and the serum hs-CRP concentration was detected with immunoscattering assay.The severity of coronary stenosis was evaluated by both diameter method and vessels scoring.Results1. BMI,WC,FBG,SBP, TG,PAI-land hs-CRP in both MS and MC groups were higher than those in normal control group (P<0.05).HDL-C was lower than normal control group (P<0. 05). TC,LDL-C,DBP in MC group were higher than those in NC group and SBP,DBP in MC group were higher than those in MS group(P<0.05).The levels of PAI-1 and hs-CRP showed MC>MS>NC(P<0.05) in three groups.2. Dividing the subjects according to age and gender,PAI-1 level was lower in premenopause females than males in NC and there was no association with age and gender in MS and MC groups.The level of serum hs-CRP was higher in females than males and was indicated to increase with age in NC group.There was no association with age and gender in MS and MC groups.3. After grouping the subjets according to BMI,the mean plasma PAI-1 and sarum hs-CRP levels were higher in obeses subjets than in no-obeses ones in NC,MS or MC groups.4. According to the results of coronary angiography in patients with CHD,the patients with mild,moderate and severe lesions were 20,18 and 22 cases respectively. The levels of PAI-1 in mild,moderate and severe lesion group were 49.73μg/L,57.93μg/L,65.41μg/L respectively;The level of PAI-1 in severe lesion group was significant higher than in mid lesion group.The levels of hs-CRP in mild,moderate and severe lesion group were 6.84mg/L,7.93mg/L, 9.71mg/L respectively;The level of hs-CRP in severe lesion group was significant higher than that in mild lesion group.5. According to the results of coronary angiography in patients with CHD,the patients with single-vessel,double-vessel and multiple-vessel were 23,20 and 17 cases respectively.The levels of PAI-1 in single-vessel,double-vessel and multiple-vessel group were 54.82μg/L,59.74μg/L, 65.49μg/L respectively;The level of PAI-1 in multiple-vessel group was significant higher than that in single-vessel group;The level of hs-CRP in singie-vessel,double-vessel and multiple-vessel group were 6.05mg/L,7.17mg/L,10.44mg/L respectively;The level of hs-CRP in multiple-vessel group was significant higher than that in single-vessel group.6. PAI-1 and hs-CRP showed positive correlations with WC and inverse correlations with HDL-C in NC, MS and MC groups. Both PAI-1 and hs-CRP were significantiy correlated with TG,LDL-C,DBP in MS and MC groups.PAI-1 was positive correlations with SBP,BMI in MS group.There were also associations between PAI-1,hs-CRP and SBP, severity of coronary stenosis and the number of vessels with lesion in MC group.The plasma PAI-1 concentration showed positive correlations with hs-CRP in three groups.7. There was a positive relationship between the level PAI-1 and severity of coronary stenosis,the number of vessels with lesion (r=0.776,0.808,p<0.01),and the level of hs-CRP was associated with severity of coronary stenosis, the number of vessels with lesion (r=0.725, 0.536,p<0.05). Conclusion1. There is close relation of plasma PAI-1 and serum hs-CRP to MS. The levels of PAI-1 and hs-CRP are involved in the occurrence and development of MS. Measurement the levels of PAI-1 and hs-CRP can be used as one of predictive factors for MS.2. The level of serum hs-CRP is indicated to increase with age and is higher in females than males, PAI-1 level is lower in premenopause females than males in normal people. There is no association with age and gender in patients with MS and MC.3. There is a significant positive correlation in PAI-1 and hs-CRP levels with severity of coronary stenosis, so PAI-1 and hs-CRP can be regarded as useful index to forecast the severity of coronary stenosis.4. The plasma PAI-1 concentration shows positive close correlations with hs-CRP,two factors interact and promote the occurence of atherosclerosis.