The Relationship Between Homocysteine, Folic Acid And Other Factors And Coronary Heart Disease/The Severity Of Coronary Artery Lesions

Objective:This study research the relationship between the homocysteine,otherralated factors and coronary heart disease(CHD) and the severity of coronary arterylesions, in order to investigate the relationship between homocysteine, folic acid andinflammatory reaction in patients with CHD, and its relationship with the severity ofcoronary artery lesion.Methods:The study included149patients who were attended in cardiovasculardepartment of our hospital from April to December in2013.There were59males and90females, aged from29to77years old(averaged56.28±9.91years old).All of thepatients were done the coronary arteriography.Recorded the general data of thereseach patients:gender, age, the history of smoking, the history of drinking,hypertension, diabetes and other past history.The next morning,when the patientswere empty stomach,then detected the liver and renal function, blood lipid, fastingblood glucose,homocysteine, folic acid, vitamin B12and high sensitivity C reactiveprotein(hsCRP),and collected the venous blood of6ml with the blood collection tubeswhich contained EDTA anticoagulant,and then centrifuged for10minuts at4000r/minin one hour,and left the supernatant,which were then storaged at-80℃refrigerator.When the samples were collected together,we detected the density ofinterleukin10(IL-10) and macrophage colony stimulating factor (M-CSF) within themethod of ELISA.According to the results of coronary angiography,the epicardialcoronary artery and its main branches at least one vessel stenosis degree reached50% for CHD,and the results were estimated by Gesini score.According to the Gesiniscore,all patients were divided into two groups,non CHD group(0-6score)and thegroup of CHD(7-144score). There were53patients in non CHD group,and96patients in CHD group.Then we divided the patients into four groups in accordancewith the coronary artery lesion,which were0,1,2,3branch group,and there were48,32,38,31patients respectively in each group.At last,we analysed the relationshipbetween homocysteine, other factors and CHD and the severity of coronary arterylesions by SPSS16.0software.Results:There were no significant statistical differences in drinking, diabetesmellitus, hypertension,triglyceride,low density lipoprotein,high density lipoproteinand cholesterol between CHD group and non CHD group（P＞0.05）.But there weresignificant statistical differences in sex, age, smoking, and fasting blood glucosebetween two group（sP＜0.05).By multivariate logistic regression analysis, suggestingthat homocysteine (OR=2.908,P=0.0411), folic acid (OR=3.032,P=0.0145), highsensitivity C reactive protein (hsCRP)(OR=2.968,P=0.0168),macrophage colonystimulatory factor (M-CSF)(OR=1.090, P＜0.001) and interleukin10(IL-10)(OR=1.503, P <0.001) have the correlation with the CHD（P＜0.05),and they werethe risk factors of CHD.But there were no correlation between CHD and vitamin B12(OR=1.497, P=0.4965)（P＞0.05).There was a correlation between folic acid andM-CSF (P=0.0134）by the general linear model analysis.The result of the linearregression analysis showed that M-CSF and IL-10were related with Gesiniscore(M-CSF：P＜0.0001；IL-10：P＜0.0001）.The value of M-CSF and IL-10concentrations increased with the number of vascular lesions.The concentration ofM-CSF and IL-10in one vessel disease group was higher than the zero vessel diseasegroup（227.58±51.59vs137.75±30.10pg/ml；37.21±17.75vs10.88±4.97pg/ml);intwo vessel disease group was higher than the one vessel disease group(253.53±41.90vs227.58±51.59pg/ml；47.24±19.10vs37.21±17.75pg/ml);in three vessel diseasegroup was higher than the two vessel disease group(300.92±48.69vs253.53±41.90pg/ml；63.94±21.18vs47.24±19.10pg/ml).And the comparison between each two groups were significant difference(P＜0.05).Conclusions:1、Homocysteine, folic acid,hsCRP, M-CSF and IL-10had thecorrelation with the CHD,and they were the risk factors of CHD.There were nocorrelation between CHD and vitamin B12.2、M-CSF and IL-10were related with theseverity of coronary artery disease,and their value of concentrations increased withthe number of vascular lesions.There was no correlation between homocysteine,vitamin B12, hsCRP with coronary artery lesions.3、There was a correlation betweenfolic acid and M-CSF,and maybe folic acid also had certain correlation with theseverity of CHD.