The Relationship Between Sex Hormone And TLR4/NF-kappa B In Postmenopausal Women With Coronary Heart Disease

Objective Observed the expressions of toll like receptor 4(TLR4) and nuclear factor kappa B( NF-kappa B) in peripheral blood mononuclear cell and the level of estradiol(E2),testosterone(T) and E2 / T in the postmenopausal women with coronary heart disease( CHD).This study was mainly to provide a theoretical basis for the prevention of postmenopausal women with coronary heart disease. Mainly divided into three aspects:(1) to explore the correlation between the expressions of TLR4 /NF-κB mRNA in peripheral blood mononuclear cellsand and coronary artery plaque stability in the postmenopausal women with coronary heart disease;(2) to explore the relationship between the level of E2, T and E2/T and the coronary artery plaque stability in postmenopausal women with coronary heart disease;(3) to explore the correlation between the level of E2, T and E2/T and the expressions of TLR4/NF- NF-κBm RNA in postmenopausal women with coronary heart disease.Methods Select 72 female patients who were in Department of Cardiology and Department of geriatrics during December 2014 to October 2015 in the First Affiliated Hospital of Shihezi University; These patients must be natural menopause more than or equal to 1 year and without taking with the sex hormone related drug. According to the diagnostic criteria of coronary heart disease in the eighth edition of clinical medicine, the postmenopausal women patients were divided into 2 groups:24 postmenopausal women with coronary syndrome acute(ACS) were enrolled in ACS group, meanwhile, 24 patients with stable angina(angina pectoris T, SAP) in SAP group and 24 patients without CHD in control group. In the second days after admission, the level of E2, T, fasting blood glucose(FBG), triglyceride(TG), total cholesterol(TC), low density lipoprotein(LDL), high density lipoprotein(HDL),apolipoprotein A(a) [Lp] in fasting venous blood, were detected by Clinical Laboratory of the First Affiliated Hospital Shihezi University; The expression of TLR4 and NF-k Bm RNA was detected by real-time fluorescence quantitative polymerase chain reaction in the Central Laboratory of the First Affiliated Hospital of Shihezi University. Collected the age, history of hypertension and diabete as baseline. The data were analyzed by SPSS20.0, the level of each variable is represented byx±s, count data were compared using χ2 test. Non normal data use the K-S nonparametric test; to compare the difference between the three groups by single factor analysis of variance. The correlation between variables was analyzed by the Pearson correlation analysis;difference was statistically significant only when P<0.05.Results Comparison of TLR4 and NF-κBp65 m RNA expression in three groups: The expressions of TLR4 and NF-κBp65 m RNA in ACS group was significantly higher than that in the SAP and the control group(TLR4: 0.54±0.35 vs 0.21±0.39; 0.54±0.35 vs 0.17±0.22, both P<0.05;NF-κBp65: 3.91±0.35 vs 2.56±0.26; 3.91±0.35 vs 1.85±0.31, both P<0.05), SAP group was significantly higher than that in control group(TLR4:0.21±0.39 vs 0.17±0.22,P<0.05;NF-κBp65:2.56±0.26 vs 1.85±0.31,P<0.05); Comparison of E2 and E2/T levels in three groups: The level of E2 and E2/T in ACS group was significantly lower than that in SAP group and control group(E2:46.15±10.79 vs 57.39±8.69; 46.15±10.79 vs 74.01±6.96, both P<0.05; E2/T: 63.11±44.29 vs 138.5±151.29; 63.11±44.29 vs 249.91±211.261, both P<0.05),SAP group was lower than that in control group( E2:57.39±8.69 vs 74.01±6.96, P<0.05; E2/T:138.5±151.29 vs 249.91±211.261, P<0.05); Correlation analysis between variables in three groups:The expression of TLR4 m RNA was positively correlated with the expression of NF-κBp65 m RNA( r=0.907, P < 0.05); The level of E2 and was significantly negatively correlated with the expressions of TLR4 and NF-κBp65 m RNA(r=-0.660、-0.708, both P<0.05); The level of E2/T was negatively correlated with the expressions of TLR4 and NF-κBp65 m RNA(r=-0.403、-0.363, both P<0.05).Conclusion This study indicates inflammatory pathways of TLR4/NF- kappa B not only involved in the formation and development of coronary atherosclerotic plaque, but also involved in plaque rupture. And low estrogen, and E2/T ratio imbalance may promote the occurrence and development of coronary heart disease in postmenopausal women, which may be because of low E2 and E2/T ratio imbalance diminish inflammation, the protective effect of anti atherosclerosis, with TLR4/NF- kappa Bp65 inflammatory pathways of excessive activation,thereby promoting the occurrence and development of arterial central sclerosis.