| Objective:To investigate the correlation between Homocysteine(Hcy),Uric Acid(UA),glycosylated Hemoglobin A1c(Hb A1c)and the severity of Coronary atherosclerotic Heart Disease(CHD)and coronary artery stenosis lesions.Methods:In this paper,a retrospective analysis was used to select patients who were hospitalized in the Department of Cardiovascular Medicine of the Second Affiliated Hospital of Nanchang University from July 2020 to July 2021 and were diagnosed with coronary heart disease by coronary arteriography(CAG)according to the inclusion and exclusion criteria.The patients(591 cases)were selected as the coronary heart disease group,and the patients(554 cases)who had been hospitalized during the same period and were clearly excluded from coronary heart disease by CAG were selected as the control group;According to CAG results,the coronary heart disease group was divided into single-vessel disease group,double-vessel disease group and three-vessel disease group.The basic data,past medical history and related biochemical indicators(including Hcy,UA,Hb A1 c,etc.)of all cases were collected,and the correlation between these factors and the severity of coronary heart disease and coronary artery disease was analyzed.Results:(1)The results of the comparison between the CHD group and the control group showed that the levels of Hy,UA and Hb A1 c in the CHD group were significantly greater than those in the control group(P<0.05),which was statistically significant.(2)The results of the comparison between the number of coronary lesions and the Gensini score grouping showed that the results of the two-to-two comparison between UA,Hcy and Hb A1 c between the three different groups showed that there was a difference(P<0.001),which was statistically significant.(3)Spearman correlation analysis results are displayed that there was a significant positive correlation between the levels of Hcy,UA and Hb A1 c and the coronary Gensini score(P<0.001).(4)Multiple linear regression analysis results showed that Hcy can significantly positively affect the coronary Gensini score,The influence coefficient is1.316>0,P<0.05,the unsortized regression coefficient is explained as the value of Hcy increases by 1,and the Gensini score increases by 1.316;UA can significantly positively affect the coronary Gensini score with an impact coefficient of 0.076>0,P<0.05,the unsortized regression coefficient is interpreted as the value of UA increases by 1,and the Gensini score increases by 0.076;Hb A1 c can significantly positively affect the coronary artery The Gensini score,with an impact coefficient of5.279>0,p<0.05,was interpreted as an increase of 1 in the value of Hb A1 c,and a corresponding increase in the Gensini score by 5.279.Standardized regression coefficient comparison(Beta): Hcy was 0.285,UA was 0.250,Hb A1 c was 0.217,and Hcy had the strongest effect on coronary Gensini score compared to UA and Hb A1 c.(5)a.Multiple logistic regression analysis results are displayed that the levels of Hcy,UA,and Hb A1 c were the risk factors for the number of coronary artery disease;when Hcy increased by 1 unit,the probability of increasing the severity of coronary artery disease stenosis by 1 degree was 1.155.times(OR=1.155,P<0.001);when the UA increased by 1 unit,the probability that the severity of coronary stenosis increased by 1 degree was 1.017 times(OR=1.017,P<0.001);when the increased Hb A1 c by 1 unit,the probability that the severity of coronary stenosis increased by 1 degree was 1.708 times(OR=1.708,P<0.05).b.Binary logistic regression analysis results are displayed that Hcy,UA,and Hb A1 c were risk factors for CHD(P<0.05): when the level of Hcy increased by 1unit,the risk of CHD increased by 1.127(OR=1.127,P<0.001).When the UA level increased by 1 unit,the risk of CHD increased by 1.017 times(OR=1.017,P<0.001);when the Hb A1 c level increased by 1 unit,the risk of CHD increased by 1.648 times(OR=1.648,P<0.001).(6)The results of ROC curve analysis show that for Hcy,the AUC of the ROC curve is 0.728(95% CI 0.699-0.756,P<0.001),and the sensitivity is 0.486 and the specificity is 0.845 when the optimal truncation value is 15.02 umol/l;for UA,the AUC of the ROC curve is 0.734(95% CI 0.706-0.763,P<0.001),with a sensitivity of 0.782 and a specificity of 0.574 when the optimal truncation value is 346.83mmol/l;for Hb A1 c,the AUC of the ROC curve is 0.656(95% CI 0.625-0.688,P<0.001),and the sensitivity is 0.403 and the specificity is 0.836 when the optimal truncation value is 6.15%.The AUC of the ROC curve jointly fitted with Hcy,UA and Hb A1 c variables was 0.805(95% CI 0.780-0.829,P<0.001),the sensitivity was0.606,and the specificity was 0.832.Conclusion:1.There was a significant positive correlation between Hcy,UA,Hb A1 c and coronary Gensini scores.2.Hcy,UA,Hb A1 c are independent risk factors for CHD and the severity of coronary stenosis.3.Combined Hcy,UA,Hb A1 c detection can better evaluate the relevant disease nd guide clinical treatment,and the three indicators should be regularly onitored for people exposed to CHD-related risk factors. |
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