| Objective This study is conducted to investigate the correlation between blood homocysteine concentration, alkaline phosphatase concentration and the degree of coronary artery calcification(expressed in calcium score).Methods The study selected 112 patients who underwent coronary CT reconstruction(64 rows) during the visit of General Hospital of Ningxia Medical University, Department of Cardiology from February 2014 to February 2015 for the study. 65 cases were male, aged 29-79(57.35 ± 11.55); 47 were female, aged 40-76(61.36± 8.67). The study excluded the subjects who had severe liver and kidney dysfunction(CTA contraindications), the subjects with hypoparathyroidism or hyperthyroidism, the subjects with malignant tumors which may cause calcium and phosphorus metabolism disorders or metastatic calcification, and the subjects who underwent coronary artery bypass surgery and had been losing artery stenting(in order to exclude the effect of metal for the calculation of calcium score), the subjects who had been taking vitamin B12 and folic acid, and other factors that may affect alkaline phosphatase concentrations: fracture healing, rickets, bone tumors, obstructive jaundice, primary and secondary liver cancer, cholestatic hepatitis. The study took full admission of the medical history of the subjects(including age, sex, height, weight, family history of coronary heart disease, hypertension, diabetes, history) and on the next morning admitted to hospital the subjects were collected venous blood to measure homocysteine, alkaline phosphatase enzymes, liver and kidney function, blood lipids, glycated hemoglobin, and CRP(C-reactive protein). According to coronary artery calcium score scan results(before conventional coronary CT scan reconstruction) calcium score by measuring the integral value of software, grouped according to the integral result of coronary artery calcification reference Rumberger classification method [1], 0 to 10 are non-calcified, more than 100 points are moderate and severe calcification. Calcification negative group are CACS0 ≤ 10 points, calcification positive group are CACS> 10 points. Using non-parametric test and chi-square test to compare every index. Using pearson correlation analysis and spearman correlation analysis, homocysteine, alkaline phosphatase and calcium score. All data applications SPSS17.0 software package for statistical analysis, all analytical results P <0.05 for the difference was statistically significant.Rusults 1.The Hcy levels in plasma is higher in non-calcified group than in the calcified group. With the degree of calcification increased, Hcy levels in plasma gradually rises successively in none-calcified group, mild calcified group, severe calcified group. The non-parametric test shows the difference between calcified group and non-calcified group, severe calcified group and mild and non-calcified group was statistically significant(P <0.05). 2. There is no obvious difference between the alkaline phosphatase and calcification and the degree of calcification. There is no statistic significance in this difference. 3. The incidence rate of hyperhomocysteinemia in calcified group is higher than in non-calcified group, but the difference was not statistically significant(P> 0.05). The incidence rate of hyperhomocysteinemia rises successively in none-calcified group, mild calcified group, severe calcified group. The difference between the severe calcified group and non-calcified group and the difference between the severe calcified group and the mild calcified group were statistically significant(P <0.05). However, the difference between the none-calcified group and the mild calcified group was not statistically significant(P> 0.05).4. Calcium score level is higher in hyperhomocysteinemia group than in none-hyperhomocysteinemia group and the difference was statistically significant(P <0.05). Calcium score level rises successively in none-hyperhomocysteinemia group, mild hyperhomocysteinemia group and moderately high hyperhomocysteinemia group, and the difference was statistically significant(P <0.05). The difference of calcium score level in none-calcified group and mild hyperhomocysteinemia group, and respectively, in none-calcified group and moderate hyperhomocysteinemia group was statistically significant(P <0.05). 5. The incidence rate of hyperhomocysteinemia in calcified group is higher than it in the none-calcified group, and it’s higher in the moderately high calcified group than in the mildly calcified group. However, the difference is not statistically significant. The difference of calcium score level in mild hyperhomocysteinemia group, and moderate hyperhomocysteinemia group was not statistically significant(P>0.05). 6. With the increase in the number of calcified blood vessels, Hcy levels in plasma, hyperhomocysteinemia incidence increases. The difference of plasma Hcy levels and hyperhomocysteinemia incidence in multivessel calcified group and 0 vessel calcified group is statistically significant.(P<0.05) ALP levels were not significantly different among groups of different numbers of vascular calcification, and the difference was not statistically significant(P>0.05). 7. Incidence rate of calcification is highest in the left anterior descending artery(P <0.05), followed by the right coronary artery(P <0.05), left main lowest(P <0.05). 8. Calcification score level and age, plasma Hcy levels, Hhcy hyperlipidemia, glycated hemoglobin, triglycerides, cholesterol, LDL has a positive correlation(P <0.05). No correlation with ALP. 9. Plasma Hcy levels in calcified group and smoking has a positive correlation(P <0.05), and has no correlation with ALP.Conclusion 1.Heart 1. With the increase of Hcy levels, coronary artery calcification significantly increased, and Hcy levels and coronary artery calcium score was a significant positive correlation, Hcy(homocysteine) was an independent risk factor for coronary artery calcification severity; 2. Hcy may cause CHD occurrence and development via calcification mechanism; 3. Age, hypertension prevalence, incidence rate of Hcy(homocysteine), incidence rate of hyperlipidemia, Apo B(apolipoprotein B) level significantly increased with the aggravation of coronary artery calcification. The factors above may be considered risk factor for arterial calcification degree.Conclusion:1. Hcy involved in coronary artery calcification process, which led to the development of CHD. 2. Hcy and smoking synergies lead to coronary artery calcification. 3. The way Hcy promote calcification is unrelated to ALP. 4. Incidence rate of calcification is highest in the left anterior descending artery, followed by the right coronary artery, left main lowest. |
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