| BackgroundCoronary atherosclerotic heart disease(CHD)is threatening the he alth of people around the world with increasing morbidity and mortality.Early prediction can help to reduce cardiovascular mortality and morbidity.With the development of research,it has been found that in addition to the traditional risk factors,there were some "The new risk factors" : metabolic related factors,lipid related components,oxidation/anti-oxidation system imbalance,inflammatory factors,etc.Finding and identifying these new risk factors,can greatly help prevent the occurrence of CHD at an early stage.Atherosclerosis(AS)is a chronic inflammatory process in which oxidative stress is the key factor.Glutamyltransferase(GGT)is a marker of cellular oxidation,which plays a crucial role in maintaining dynamic equilibrium of glutathione(GS H)and resisting oxidation irritable reaction.Epidemiology suggested that the elevated level of plasma GGT was related to the occurrence and development of atherosclerotic and CHD as well as its clinical events.In addition,AS not only has been proved t o be a simple endothelial injury and lipid infiltration,but also an active inflammatory process,Pathological experiments found that lymphocytes(LY)are present in atherosclerotic plaques,which are involved in the development of atherosclerotic plaques.With the effect of chemokines and adhesion molecule,LY and macrophages migrate from the blood to the sub endothelium of the artery and turn into foam cells.In the relevant literature,the platelets-to-lymphocytes ratio and neutrophils-to-lymphocytes rat io are associated with the diagnosis and severity of CHD.GGT and LY are jointly involved in the pathological mechanism of coronary atherosclerosis.The glutamyltransferase-lymphocyte ratio(GLR)seems to be a better predictor than GGT or LY alone.Recent s tudies have found that GLR is associated with prognosis after radical resection of hepatocellular and pancreatic cancer.However,the correlation between GLR and AS or C HD is still uncertain.So far,there is a lack of reported about the correlation betwee n GLR and CHD or the severity of coronary artery lesions in the domestic and overseas.ObjectiveTo investigate the relevance of GLR and cor onary heart disease orseverity of coronary artery lesions MethodsRetrospective study was performed on patients in the department of Cardiology of the First Affiliated Hospital of Shantou University Medical College from January2017 to June 2020.There were 3506 patients enrolled according to the standard of inclusion and exclusion criteria.Clinical baseline data,fasting venous blood routine,biochemical indicators at admission or next morning and coronary angiography results were collected.According to c oronary angiography,they were divided into CHD group(CAG showed stenosis of one coronary vessel≥50%,n=2389,CCS group=979,ACS group =1410)and non-CHD group(CAG showed stenosis of all coronary vessels<50%,n=1117,Normal group =607,AS group =510)were used as control group.According to the number of diseased vessels,CHD group was divided into three groups:1vd group(n=883),2vd group(n=672),3vd group(n=834).In addition,according to the coronary angiography,C HD group was grouped according to the three quartiles of the Gensini score: low integral group(0-24 points,n=807),medium integral group(24-56 points,n=797),and high integral group(56-200 points,n=785).All data were processed and analyzed with IBM SPSS 24.0 software,p<0.05 was statisticall y significant.Results1.GLR[1.74(1.05,3.03)] in the CHD group was significantly higher than that in the non-CHD group [0.89(0.61,1.36)],and there was a statistical difference between the two groups(p<0.001).The non-C HD group was further divided into N ormal group and AS group,the CHD group was divided into CCS group and ACS group.GLR was significantly increased in the ACS group [2.18(1.35,3.75)],while GLR in the CCS group [1.22(0.84,2.05)] and the AS group GLR [0.93(0.66,1.43)]level were higher than in Normal group GLR [0.85(0.57,1.30)],the difference was statistically significant.(p<0.05).2.Comparison among 3vd group,2vd group,1vd group and 0vd group.GLR level in3 vd group [1.96(1.21,3.32)],2vd group [1.87(1.06,3.29)] and 1vd group [1.43(0.89,2.57)] were higher than 0 vd group [0.89(0.61,1.36)],and the difference was statistically significant(p<0.05).But there was no statistical difference between 3vd group and 2vd group(p>0.05).3.Comparison among the high,medium and low Gensin i scoring groups : GLR level in high group[2.15(1.34,3.74)],medium group[1.9(1.11,3.21)and low group[1.25(0.82,2.1)]showed an increasing trend.There were statistically significant difference(p<0.05).4.Spearman correlation analysis showed that GLR was posi tively correlated with Gensini score(r=0.286,p<0.001).5.The multivariate Lo gistic regression analysis was used to calibrate statistically significant traditional risk factors,and GLR could be used as an independent risk factor for CHD [OR=4.062,95%CI:3.4 13-4.835,p<0.001].6.The ROC curve analysis showed that the AUC of GLR for CHD prediction was0.755[Se=0.008,95%CI:0.738-0.771,p<0.001] when GLR=1.43,it was the best prediction bound value,and the corresponding sensitivity and specificity were59.6% and 77.8%.Conclusions1.GLR is associated with plaque stability and complexity of coronary artery lesions.2.GLR ma y be an independent predictor of coronary heart disease... |
PDF Full Text Request