Relationship Between Serum Gamma-glutamyltransferase Levels And Severity Of Coronary Artery Lesions In Patients With Coronary Heart Disease

Objective:To study the relationship between serum gamma-glutamyltransferase(GGT)and the severity of coronary artery lesions in patients with coronary heart disease,and to explore its predictive effect on the severity of coronary artery lesions.Methods:We enrolled 397 patients with CHD who underwent coronary angiography from June 2016 to December 2016 in the department of cardiology of the First Hospital of Jilin University,according to the inclusion criteria and exclusion criteria.After calculating the Gensini score,the patients were divided into three groups:low score group(0<point?28),medium score group(28<point?55),high score group(point>55).After collecting the clinical basic data and serum indicators,including white blood cell(WBC),neutrophil(NE),hemoglobin(HGB),platelet(PLT),blood urea nitrogen(BUN),creatinine(Cr),GGT,alanine aminotransferase(ALT),aspartate aminotransferase(AST),alkaline phosphatase(ALP),total cholesterol(TC),triglyceride(TG),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),fasting blood glucose(FBG),left ventricular ejection fraction(LVEF),left ventricular enddiastolic diameter(LVED)and angiographic results.SPSS25.0 statistical software was adopted,One-way analysis of variance,Rank sum test and Chi-square test were applied to compare whether the data of three groups were statistically different,Spearman correlation analysis was used to analyze the correlation between GGT,Gensini score and other indicators,Multivariate ordered logistic regression analysis was used to analyze risk factors of severity of coronary artery lesions,ROC curve was used to explore the predictive effect on the severity of coronary artery lesions of GGT.Results:1.Comparison of basic data of three groups:397 patients were included in the study.There was no significant difference in age,gender,smoking,and history of hypertension and diabetes among the three groups(P>0.05).LVED and LVEF had statistical significance among the three groups(P<0.05).Compared with the low score group,LVED was significantly higher in the high score group,LVEF of the medium and high score groups were statistically significantly lower as well(adjuested P<0.05).2.Comparison of serological indexes among three groups:There was significant difference in the level of WBC,NE,PLT,GGT,ALT,AST,ALP,FBG among the three groups(P<0.05).Compared with the medium and low score group,the high score group had significantly higher level of WBC,NE and AST.The level of GGT,ALT,ALP and FBG in the high score group were also statistically significantly higher than the low score group(adjuested P<0.05),while there was no significant difference among the three groups with regard to the level of HGB,BUN,Cr,TG,TC,LDL-C,HDL-C(P>0.05).3.Correlation analysis between GGT levels and other factors:Spearman correlation analysis showed that GGT level was positively correlated with the level of ALT,AST,ALP,FBG,TC,TG(P<0.05).4.Correlation analysis between Gensini score and other factors:Spearman correlation analysis showed that Gensini score was positively correlated with the level of WBC,ALT,AST,ALP,GGT,LDL-C and FBG(P<0.05),there is no correlation between HDL-C and Gensini score(P>0.05).5.Multivariate ordered logistic regression analysis:the results showed that the level of WBC and GGT were associated with Gensini score,and elevated level of WBC and GGT were independent risk factors for high Gensini score(P<0.05).6.ROC curve analysis:The ROC curve showed that the area under the curve of GGT was 0.589(95%CI:0.531 to 0.647).When the critical value of GGT was 58.55U/L,the efficiency of predicting high Gensini score is the highest.Conclusion:1.In patients with coronary heart disease,the level of serum GGT is positively correlated with the severity of coronary artery lesions.2.Elevated serum GGT level is independent risk factor for the severity of coronary artery lesions.3.Serum GGT can be used as an indicator to predict the severity of coronary artery lesions in the clinical practice.