| Objective: To explore the relationship between serum levels of angiopoietin like protein3(ANGPTL3)and retinol binding protein 4(RBP4)and the severity of coronary artery disease(CAD)in patients with atherosclerotic heart disease.Methods:A total of 236 patients who underwent coronary angiography were enrolled in the Affiliated Hospital of Medical Collage from October 2019 to October 2020.According to the diagnosis and coronary angiography results,they were divided into CHD group(187 cases)and control group(49 cases).According to the diagnosis,the CHD group was divided into acute coronary syndrome group(ACS group)(136 cases)and angina pectoris group.According to the angiography,the CHD suit was changed into single disease suit,double disease suit and triple disease suit based on the results of coronary angiography.Two cardiologists independently calculated the Gensini scale according to the results of arterial imaging,the severity of coronary artery lesions was evaluated by Gensini scale.Serum levels of ANGPTL3 and RBP4 were measured by ELISA method,and the patients’ medical history and examination results were recorded,including gender,age,history of hypertension,smoking history,LDL-C,HDL-C,triglyceride TG,cholesterol and cholesterol etc.To analyze and compare the correlation between serum ANGPTL3 and RBP4 levels and Gensini scores in patients with coronary heart disease group,and to analyze the differences in ANGPTL3 and RBP4 levels in subjects with different lesion numbers.Pearson correlation analysis was used to investigate the correlation between clinical parameters and ANGPTL3 and RBP4.Logistic regression analysis was used to investigate the relationship between ANGPTL3,RBP4 and the severity of CHD.The corresponding P value was calculated,and when P < 0.05,the difference was considered statistically significant.Results:1.The level of ANGPTL3 in the CHD group was significantly higher than that in the control group(0.40±0.06ng/ml vs 0.32±0.06ng/ml,P < 0.001).The level of serum ANGPTL3 in ACS group(0.41±0.05ng/ml)was higher than that in SAP group(0.36±0.05ng/ml)and control group(0.32±0.06ng/ml),and the level of serum ANGPTL3 in SAP group(0.36±0.05ng/ml)was higher than that in control group(0.32±0.06ng/ml)(P < 0.05).2.The level of RBP4 in the CHD group was significantly higher than that in the control group(43.54±11.29mg/L vs 35.31±7.95mg/L,P < 0.001).Serum RBP4 level in ACS group(44.42±10.70mg/L)and SAP group(41.21±12.57mg/L)was higher than that in control group(35.31±7.95mg/L)(P < 0.05).Compared with SAP group(41.21±12.57mg/L),the serum RBP4 level in ACS group(44.42±10.70mg/L)had no statistical significance(P > 0.05).3.Pearson correlation analysis was used to analyze the correlation between ANGPTL3,RBP4 levels and clinical parameters in patients with CHD.ANGPTL3 was positively correlated with TC(r=0.271,P < 0.001),TG(r=0.403,P < 0.001),LDL-C(r=0.295,P < 0.001),and Gensini score(r=0.236,P < 0.05),while negatively correlated with HDL-C(r=-0.260,P <0.001).RBP4 was positively correlated with TC(r=0.181,P < 0.05),TG(r=0.229,P < 0.05),LDL-C(r=0.181,P < 0.05),Hcy(r=0.145,P < 0.05),UA(r=0.189,P < 0.05)and Gensini score(r=0.191,P < 0.05).4.Comparison of data of patients with different lesions:Gensini score(47.25(36.00,72.00)vs 31.00(20.00,40.00)),serum LDL-C(2.46±0.86mmol/L vs2.12±0.66mmol/L),ANGPTL3(0.42±0.05ng/ml vs 0.39±0.06ng/ml),RBP4(50.56±13.40mg/L vs 38.99±9.67mg/L)in the three-vessel lesion group were higher than those in the single-vessel lesion group.The levels of Gensini score(47.25(36.00,72.00)vs 36.00(25.00,49.00)),serum ANGPTL3(0.42±0.05ng/ml vs 0.39±0.06ng/ml)and RBP4(50.56±13.40mg/L vs 43.85±8.27mg/L)in the three-vessel group were higher than those in the double-vessel group(P < 0.05).5.Logistic regression analysis was used to investigate the relationship between ANGPTL3,RBP4 and CHD: after adjusting for confounding factors,ANGPTL3 was an independent risk factor for CHD(OR=4.88,95%CI 2.82-8.47,P <0.001).After adjusting for confounders,RBP4 was an independent risk factor for CHD(OR=1.06,95%CI 1.03-1.11,P=0.015).Conclusion: The level of serum ANGPTL3 in patients with coronary heart disease is higher than that in control group.The level of serum ANGPTL3 is an independent risk factor for coronary heart disease,and is positively correlated with the degree of coronary artery disease.Serum RBP4 level in CHD patients was higher than that in the control group.Serum RBP4 level was an independent risk factor for CHD and positively correlated with the degree of coronary artery disease.Serum ANGPTL3 level is positively correlated with serum TC,TG and LDL-C level,and negatively correlated with serum HDL-C,suggesting that ANGPTL3 is involved in lipid metabolism.Serum RBP4 levels were positively correlated with serum TC,TG and LDL-C levels,which proved that RBP4 was involved in lipid metabolism.In conclusion,ANGPTL3 and RBP4 are both risk factors for CHD,and are positively correlated with the severity of coronary artery disease in CHD patients. |
