Relationship Between Serum CTRP9 And TLR4 Levels And C-IMT And Coronary Heart Disease

Objective:Coronary heart disease(CHD)has become the leading cause of death worldwide,and its prevalence has increased year by year,accompanied by tremendous economic and social pressure.The search for an early screening method for CHD has become an urgent problem for medical workers.Recent studies have found that C1q/Tumor necrosis factor related protein 9(CTRP9)has functions of regulating metabolism,protecting myocardium,improving endothelial function,and resisting cardiovascular damage in diabetes.It is independent of adiponectin(Adiponectin,APN)Assessing Factors of Cardiovascular Events.Toll-like receptor 4(TLR4)is involved in the development of inflammation,autoimmunity,cardiovascular disease,and tumor as immune mediators.Studies have confirmed that TLR4 and CHD are inextricably linked.Carotid Artery Intima-media Thickness(C-IMT)can reflect the degree of atherosclerosis(AS)and correlate with the degree of CHD,which can be used as an important factor in assessing the risk of cardiovascular events.By measuring serum CTRP9,TLR4 concentration and C-IMT in patients with coronary heart disease,to explore serum CTRP9,TLR4 concentrations and the correlation between C-IMT and coronary artery disease in CHD patients,in order to provide more accurate screening for CHD and assessment of coronary artery disease levels.And economic inspection measures.Methods:We selected 106 patients with coronary angiography(Coronary Angiography,CAG)from January 2017 to November 2017 in the Department of Cardiology,the Second Hospital of Hebei Medical University,including 28 in the permanent control group and 78 in the CHD group.Patients were again grouped according to the number of coronary lesions and coronary Gensiniscores.The basic clinical data of all selected participants were collected and serum CTRP9 and TLR4 concentrations were detected by ELISA.All candidates were required to undergo CAG and carotid ultrasound and record C-IMT.Compare the differences between the parameters in each group.Results:1 The serum concentration of CTRP9 in the CHD group was significantly lower than that in the control group(P<0.001);The serum TLR4 concentration and C-IMT in the CHD group were significantly higher than those in the control group(P<0.001).2 Comparison of serum CTRP9,TLR4 concentration and C-IMT in patients with different degrees of coronary artery disease.2.1 CHD patients were grouped according to the number of coronary lesions,CTRP9 and TLR4 concentrations and C-IMT in each group were compared and the differences between the groups were significant(P<0.001),indicating that serum CTRP9 concentration increased with the number of coronary lesions increased.Gradually decreased,serum TLR4 concentration and C-IMT gradually increased.2.2 CHD patients were grouped according to the coronary Gensini score,the serum CTRP9,TLR4 concentration and C-IMT in each group of patients were compared,the difference between the groups was significant(P<0.05),indicating that as the coronary Gensini score increases,the serum CTRP9 concentration gradually Decreased,serum TLR4 concentration and C-IMT gradually increased.3 Linear correlation analysis: Serum TLR4 concentration and C-IMT were positively correlated with coronary Gensini score(r=0.705,P<0.001),(r=0.618,P<0.001).Serum CTRP9 concentration was negatively correlated with coronary Gensini score.(r=-0.696,P<0.001).Multiple linear regression analysis was performed using the coronary Gensini score as the response variable.The results showed that serum CTRP9,TLR4 and C-IMT were independent factors of coronary Gensini score.4 The ROC curve showed that the area under the ROC curve(AUC)of serumCTRP9 combined with C-IMT was 0.912,and the AUC of serum TLR4 combined with C-IMT was 0.949.Using a combination of two indexes can increase C-IMT screening for CHD and assessment of coronary artery.The accuracy of the vein lesions.Conclusions:1.Serum CTRP9,TLR4 concentration and C-IMT are closely related to the degree of coronary artery lesions and are independent predictors of CHD.2.Serum CTRP9 combined with C-IMT or serum TLR4 combined with C-IMT can increase its clinical value in the screening of coronary heart disease and assess the degree of coronary artery disease.