Analysis Of The Relationship Between PTH, 25(OH)D And The Degree Of Coronary Artery Stenosis In Patients With Coronary Heart Disease In Xining Area

Objective:To investigate the correlation between parathyroid hormone(PTH)and 25 hydroxy vitamin D(25(OH)D)and the severity of coronary lesions,so as to provide new reference indexes for the diagnosis and treatment of patients with coronary heart disease,as well as the evaluation and prognosis of patients.Methods:320 patients with suspected coronary heart disease in the Department of cardiovascular medicine of Qinghai Provincial People’s hospital were selected,from October 2018 to September 2020.Among them,155 cases were male,accounting for 48.3%,and 165 cases were female,accounting for 51.7%.The average age was between 60-75 years old.There were 150 cases in the normal coronary artery group,accounting for 46.9%,and 170 cases in the coronary artery stenosis group,accounting for 53.1%,and all patients had no contraindications for coronary angiography,and all met the indications for coronary angiography.According to the results of coronary angiography,they were divided into normal coronary artery group(CAN)and coronary artery stenosis group(CAS).Then the selected patients were scored according to the Gensini score for the degree of coronary artery lesions,and grouped according to the obtained Gensini results.They were divided into Group Q1(n=43 cases)with Gensini score<10,Group Q2(n=45 cases)with Gensini score of10-25,group Q3(n=42 cases)with Gensini score of 25-45,and group Q4(n=40cases)with Gensini score>45.The levels of PTH and 25(OH)D in each group were monitored,and then the statistical analysis was performed.Finally,the research results were obtained.Results:(1)There was no significant difference in age,sex,history of hypertension,smoking history,UA,BMI,TG and LDL-C between CAS group and CAN group,but there were significant differences in PTH and 25(OH)D between the two groups.(2)The level of 25(OH)D in CAS group was lower than that in CAN group[(45.23±11.82)nmol/lvs(36.22±7.83)nmol/l],and the level of PTH in CAS group was higher than that in CAN group[(50.92±9.94)pg/mlvs(53.14±8.92)pg/ml].It is suggested that there is a correlation between the levels of PTH and 25(OH)D in evaluating the degree of coronary artery stenosis in patients with coronary heart disease.(3)To evaluate the correlation between the levels of PTH and 25(OH)D in patients with CHD and the degree of coronary artery stenosis.Using Spearman correlation analysis,it was found that there was a positive correlation between the level of PTH and the degree of coronary artery stenosis in patients with CHD(r_s=0.685 p<0.05).The level of25(OH)D was negatively correlated with the degree of coronary artery stenosis(r_s=-0.786 p<0.05).In the binary Logistic regression model,the dependent variable was the degree of coronary artery stenosis,and the covariables were sex,age,smoking history,hypertension history,TG,LDL-C,BMI,PTH,25(OH)D and so on.Finally,binary Logistic regression analysis was carried out when other factors were relatively fixed.The results suggest that the gradual decrease of 25(OH)D level(OR=1.607 p=0.000)and the gradual increase of PTH level(OR=1.432 p=0.002)are the risk factors related to the degree of coronary artery stenosis in patients with CHD.Conclusion:(1)The levels of PTH and 25(OH)D have certain reference value in patients with coronary heart disease and can be used as one of the reference risk factors of coronary heart disease.(2)There is a certain correlation between the levels of PTH and 25(OH)D and the degree of coronary artery stenosis in patients with coronary heart disease.(3)There is a correlation between the levels of PTH and 25(OH)D and coronary atherosclerotic heart disease in Xining.