Correlation Study Of Estrogen And Seurm Bilirubin On Postmenopausal Women With Coronary Heart Disease

BackgroundWith the rapid development of social economy in our country,the growth in living standard,diseases of the cardiovascular system holds a significant constituent ratio in death cause,seriously affecting people’s quality of life and life span and has great harm to human survival.Coronary heart disease has important position in the diseases of cardiovascular system,its development is associated with genetic and environmental factors, and the incidence of male and female is obvious different. CHD is coronary atherosclerosis which leads to myocardial ischemia and hypoxia, then reducing people’s labor load, even threatening the lives of patients. In recent years, with the deepenly research about pathogenesis and risk factors of related foudation and clinical characteristics of coronary heart disease,people had a deeper understanding about the occurrence and development of coronary heart disease,even take advantageous measures for prevention from coronary heart disease, and established tertiary prevention mechanism, significantly reducing the mortality rate and incidence of coronary heart disease. But when we observed after the gender classification that the incidence of CHD in women have not distinctly improved, especially in postmenopausal women crowd.Epidemiological studies have shown:The incidence of coronary heart disease (CHD) is lower in women than men of the same age. The gap between the2sexes closes after menopause,when the incidence of male and female has no obvious difference[1].The occurrence and development of cardiovascular system disease in the2sexs have several different factors,the most important is the estrogen level. Studies have found that estrogen is strongly related to the occurrence of atherosclerosis[2]. Therefore,people gradually make the important role of estrogen for the coronary heart disease of women as a clinical observation and animal experimental study index. Also in the correlation study about risk factors of coronary heart disease,we can found that bilirubin is a protective factor for coronary heart disease which generated by heme degradation in the human body,but recently study found that low level bilirubin is one of the risk factors of coronary heart disease. Literature research at home and abroad often research the relationship between estrogen or bilirubin and coronary heart disease of female.but a few articles involving the relationship between estrogen and bilirubin,and the role of them in the occurrence and development of cardiovascular system disease.This article will discuss the metabolism relations between estrogen and bilirubin,and the the effect of them to the coronary heart disease.Objective1. To investigate the correlation between estradiol (E2) and the traditional risk factors of CHD and Through non-conditional multiple logistic regression analysis to determine whether estradiol is an independent protective factor of CHD.2. Through the analysis relationship of E2and high-sensitivity C-reactive protein(hs-CRP),angiotensin converting enzyme (ACE),total bilirubin (TBIL) preliminary discussion the mechanism of low level E2leading to the occurance of CHD.3. Through correlation analysis of estradiol (E2) and serum total bilirubin (TBIL),preliminary discussion endogenous E2influence possible metabolism mechanisms of TBIL. MethodsOne hundred and four patients were enrolled in this clinical trial,who were selected from the inpatients of our department of cardiology from2011and Oct2012,all the selected patients received coronary angiography. According to the results of coronary angiography,all patients were divided into CHD group (46cases) and control (NC) group (58cases).The fasting total serum estradiol (E2), high-sensitivity C-creactive protein(hs-CRP),serum levels of total cholesterol (TC),angiotensin converting enzyme (ACE) and total bilirubin(TBIL) were measured respectively in the two groups.Prior medical histories including:essential hypertension,diabetes mellitus,age,menopause age.To analysis the E2and TBIL leval between two group,as dependent variable CHD;TC,ACE,E2,hs-CRP, TBIL, menopause age,age,essential hypertension,diabetes mellitus as independent variables, as many factors through Logistic regression analysis,and analysis the level of plasma E2,age,hs-CRP,ACE,TBIL in selected patients.Results1. The blood hs-CRP,ACE,TBIL,TC levels of CHD group were much higher than those of NC group (P<0.05),E2was much lower than NC group (P<0.05), but the age of menopause there was no discrepancy in levels of between CHD group and NC group.2. The E2level of CHD group was much lower than NC group (P<0.05),After many factors unconditional Logistic regression anylysis,E2relative risk for CHD (OR) was0.987(P<0.05).3. E2and age,hs-CRP,ACE all had negative correlation (P<0.05), while TBIL had positive correlation with E2(P<0.05).Conclusion1. Estradiol (E2) is a protection factors for coronary heart disease of female. Postmenopausal along with the increase of age, E2level will continuly drop.2. Estradiol may through the protection from the inflammatory damage of endothelial cell, preventing the formation of atherosclerosis.3. Estradiol may affect the metabolism of bilirubin in women, through the antioxidant effect, further strengthen its protection of blood vessels.