Relationship Between Homocysteine,Oxidized Low Density Lipoprotein And Carotid Intima-media Thickness In Elderly Patient With Coronary Heart Disease

Objective:To observe the relationship of plasma homocysteine(Hcy),oxidized low density lipoprotein(OX-LDL)and carotid intima-media thickness(IMT) and to observe the effect and interaction of Hcy and OX-LDL in the atherosclerosis process.Methods:51 elderly patients with coronary heart disease were selected according to the diagnosis criterion made by WHO in 1979.All the patients aged 60 to 82 years including 43 men aged 69.52±9.4 and 8 menopause women aged 70.0±6.7years.Patients with acute coronary syndrome,diabetes,severe malnutrition,serious hepatic and renal dysfunction,malignant anemia were eliminated. Carotid arteries were measured with HP2500 2D-ultrasound.All patients were avoided to eat high-protein food for 3 days before the blood samples were taken. the plasma were Seperated from the blood in 30 minutes after the blood samples being taken.The plasma was keeped in -72℃ refrigerator and measured lately.The reagants were provided by German Axis-Shield company(Hcy) and ShangHai rongshengfactory(OX-LDL).Ultrasonography of both carotid artery intima-media thickness were proformed using a 7.5MHz high frequency linear array transducer of HP2500 made in U.S.A. The 1-cm segment proximal to the dilation of the carotid bulb was selected as the scanning district. The distance between the leading edge of the first bright line of the post wall (lumen-intima interface) to the leading edge of the second bright line (media-adventitia interface) indicated the carotid IMT.All the data were used SPSS10.0 software pack to make statistical analysis. Initially the homogeneity of variance between all the groups was analyzed. All the measurement data was denoted by mean±standard deviation and students t test was used to establish significance. ANOVA was used to compare the difference between the groups.Chi-square test was used to compare Enumeration data about difference of rate between the groups. Correlation test was used to measur the coefficient of correlation about the correlation data. We took p＜0.05 as statistic significance level. Result :1.43 elderly men and 8 elderly menopause women were studied .All the patient were divided into two groups according to the level of Hcy :high Hcy level group (Hcy>15μmol/L) and normal Hcy level group (Hcy≤15μmol/L).2.There were no statistical differences between both groups about age,hypertension,serum lipids(includingTG,TC,LDL,),smoking history.3. The catotid IMT was 0.9332±0.19178mm in high Hcy level group and 0.8245±0.18321mm in the normal Hcy group respectively p<0.01. The plasma Hcy and carotid IMT had positive correlation(r=0.452 p<0.05).4.OX-LDL and carotid IMT had positive correlation(r=0.523 p<0.05).5.OX-LDL/LDL in the high Hcy group was 0.9597±0.61464μg/mg and was 0.5902±0.28745μg/mg in the normal Hcy level group and statistical difference was found (p<0.05); The plasma Hcy and OX-LDL/LDL had positive correlation(r=0.753 p<0.05).Concolusions:1.About 31.37% elderly patients with coronary heart disease had a high level plasma Hcy and in the normal poeple it is only 1.5%. Hcy had no effect on hypertension,serum lipids(includingTG,TC,LDL).2. Hcy was a indenpendent risk factor of AS in elderly patients with coronary heart disease. Hcy could aggravate the AS that has been exited .3. OX-LDL was also a risk factor of AS in elderly patient with coronary heart disease.4.Accelerating the AS processing OX-LDL could be one of the way that Hcy effected AS.