The Study Of The Liver Enzymes And Serum Bilirubin In The Patients With Coronary Hert Disease And Metabolic Syndrome

Objection:To study the relationship between the plasma levels of TBiL、GGT、ALT and coronary heart disease and coronary artery stenosis degree in the patients with Metabolic syndrome. The levels of serum TBiL、GGT、ALT maybe play an useful prediction index in the early detection and treatment of coronary heart disease in patients with metabolic syndrome.Methods:1. Research objects and groups:A total of 2055 patients in this study were from the First affiliated of Guangxi Medical University in May,2012 to December,2014, who had done the coronary angiography examination. Age 27-89(59.99±10.62) year old, including 1512 men and 543 women.. Group them into two groups by coronary angiography results. The control group(Group N n=190) including 111 men and 79 women、CHD (Group G n=1855) including 1402 men and 463 women), then group CHD into two groups:CHD with MS (Group G1 n=1312) including 985 men and 327 women). And without MS (Group G2 n=553) including 417 men and 136 women.2. Check projects:(1) All patients after in hospital the next morning empty stomach tested the following indicators in the study, including blood routine, the level of serum gamma-glutamy transpeptidase (GGT),alanine aminotransferase(ALT),total bilirubin(TBiL),total cholesterol(TC),tiacylglycerol (TG),low density lipoprotein cholesterol (LDL-C),high density lipoprotein cholesterol (HDL-C), homocysteine (HCY),Fasting blood glucose (FBG),Postprandial blood glucose(PBG)、hemoglobin A1c (HbA1c),Uric acid (UA) and so on. Above all done by professional staff to collect the research object of fasting blood samples, and the first affiliated of Guangxi medical university clinical laboratory using Hitachi automatic biochemical analyzer,7600-020.Determination of serum glucose oxidase method. Glycated hemoglobin (HbAlc) by the firt affiliated hospital of Guangxi medical university clinical laboratory use east cao HLC-723 glycated hemoglobin analyzer measurement. (2) And some basic information. The blood pressure、the computation body weight index and the coronary artery angiography were performed.3. The results of coronary angiogram and to calculate Gensini score by the results.4. Statistical method:Using the T-test, Chi-square test、One-Way ANOVA、the straight line correlation analysis and the multi-factor regression analysis to deal with data.Results:1. Basic data comparison1.1. Basic data comparison between CHD group and the control group.The percentage of males、smokers、drinkers and the patients with a history of hypertension、diabetes are significantly higher in CHD than in the control group(P< 0.05), also the BMI、age、SBP and DBP are higher than the control group (P<0.05).1.2. Basic data comparison between G1 group and group G2The percentage of the patients with a history of hypertension、diabetes are significantly higher in group G2 than in the group G2(P< 0.05), also the BMI、age and DBP are higher than the group G2 (P<0.05).2. The comparison of biochemical factors between CHD and controls:There is a significant difference when compare the level of serum TG、UA、LDL-Cto CHD and controls (P<0.05),and the levels are higher. The are no significant difference in AST (P> 0.05). The level of serum HDL-C is obviously lower than that in controls (p<0.01).3. The comparison between group G1 and group G2.The levels of serum TG、UA、FBG、PBG are significantly higher in group G2 than in group G1 (P<0.05).The level of serum HDL-C is obviously lower than that in group G1 (P<0.05).4 The comparison of liver enzymes between group G1、group G2 and controls; the comparison of Gensini score between group G1 and group G2..4.1 Three groups of serum GGT、ALT levels overall trend from the control to the group G2 increase, which highest level is CHD with MS, followed by CHD and the lowest for the control. The neighboring two groups of difference has statistics significance (P< 0.05). The levels of serum TBiL、 DBiL、IBiL during three groups of comparison, three groups of serum TBiL、 DBiL、IBiL levels with the increase of Gensini integral and gradually decline, including the highest level of serum TBiL、DBiL、IBiL in the control, followed by CHD group, the lowest for the CHD with MS group. The neighboring two groups of difference has statistics significance (P<0.05)6. The relationship between serum GGT、ALT、BiL and components of metabolic syndrome.Serum GGT、ALT and BMI、PBG、TG、TC were positively correlated and were negatively correlated with HDL-C, serum TBiL and PBG、BMI、TG、 TC were negatively correlated, serum DBiL and PBG、TG、TC、LDL-C were negatively correlated, serum IBiL and SBP、DBP、TG、TC、LDL-C were negatively correlated and positively with HDL-C.7. The result of multivariable conditional regression.Eliminate the traditional risk of coronary heart disease, such as gender, BMI, high UA and low HDL-C and so on, also, this study shows that the high GGT, ALT and low TBiL are independent risk factors for coronary heart diseas.Conclusion1. The levels of serum GGT、ALT are higher in the patients with coronary heart disease than the patients who without coronary heart disease. The level of serum BiL is down. Elevated serum ALT、GGT and reduced serum TBiL are all independent risk factors for coronary heart disease.2. The levels of serum GGT、ALT are higher in the patients with coronary heart disease and metabolic syndrome than the patients who without metabolic syndrome. The level of serum BiL is down..3. The level of serum GGT、ALT and BiL may provide a new biochemical factors for the diagnosis and treatment of coronary heart disease, especially for the patients with metabolic syndrome.