Study On The Association Of Estrogen With Serum Lipids Levels And Severity Of Coronary Artery In Female Patients With Coronary Heart Disease

Objectives:To detect the concentrations of high-density lipoprotein(HDL) and its subclasses, low-densitylipoprotein(LDL), total cholesterol (TC), triglycerides (TG), estradiol (E2) and clear the coronary artery disease extent by coronary angiography (CAG) in women patients of Coronary heart disease(CHD) in order to further explore the impact of estrogen on female patients with serum lipid levels and coronary artery disease extent.Methods:269cases of female patients are selected from September2011to January2013in Tianjin Chest Hospital inpatients. According to the result of CAG, all the subjects are divided into CHD group with184cases, age62.74±6.96years old, and the control group with85cases, age61.42±7.47years old. The subjects of CHD group were divided into four groups according to the Gensini score interquartile:I group(<19.5scores) with47cases, II group (19.6-37scores) with48cases, III group (37.1-66scores) with44cases and IV (≥66.1scores) group with45cases. Then selected27cases from all the subjects into group A, who were premenopausal,age51.48±3.42years old,87cases into group B, who were in menopause less than10years(including10years), age58.25±3.58years old, and the rest of all the subjects who have been in menopause more than10years into group C, age66.50±5.64years old. In the next morning of admitted to hospital,all the subjects were taken fasting elbow venous blood, then the serum was separated. The concentrions of HDL-C and its subclasses were measured by PEG20000precipitation and enzymatic method, TC TG and LDL-C by endpoint colorimetric determination, and E2by radioimmunoassay method.Results:1. CHD group compared with the control group:the concentrations of serum TC,LDL-C in CHD group showed significantly higher than the control group, and the concentrations of HDL-C and its subclasses(HDL2, HDL3), E2showed a inverse trend (P＜0.05)2. The Gensini integral quartile grouping showed that the levels of serum HDL-C,HDL3and E2were significantly lower (P＜0.05to0.01) with the Gensini score increased, the levels of E2, HDL-C, HDL3was negatively correlated to the Gensini score (r=-0.240,-0.171,-0.209, P＜0.05), but TC, TG and LDL-C have no statistically significance(P>0.05).3. With the extension of the menopause,the concentrions of serum E2, HDL-C and HDL3decreased significantly(P<0.01to0.05), and the Gensini integral significantly increased(P<0.01). E2was positively correlated to HDL-C and HDL3(r=0.396,0.371, P＜0.01).4. Using multi-factor Logistic regression analysis showed that history of smooking and the decrease concentrions of serum E2, HDL2and HDL3are the independent risk factors of women with CHD(P<0.05).Conclision:1. The levels of serum TC, LDL-C of CHD group were higher those in the control group,and the levels of HDL-C and its subclasses (HDL2, HDL3) were lower, which indicated that the increase of TC,LDL-C and the decrease of HDL-C and its subclasses are closely related to CHD.2. Serum E2, HDL-C and HDL3levels were negatively correlate to Gensini score,suggesting that the detection of these indicators may aggravate the degree of coronary artery lesions.3. Multi-factor Logistic regression analysis showed that history of smooking and the reduce of E2, HDL2and HDL3levels are the independent risk factors, which indicated that should pay attention to older women in the clinical risk of coronary heart disease.4. The concentrions of E2was positively correlated to HDL-CHDL3levels, suggesting that estrogen may play a role in protection of women’s cardiovascular through regulating HDL-C and HDL3levels.