The Relationship Between Serum Levels Of SFRP5,YKL-40,PLR And Coronary Artery Disease

Objective:To study the relationship between the levels of sereted frizzled related proteins 5(SFRP5),chitinase protein 40(YKL-40),platelet to lymphocyte ratio(PLR)and the degree of coronary artery stenosis in patients with coronary artery disease(CAD).And provide more references for its clinical application in the future.Methods:A total of 166 patients who underwent coronary angiography in the Department of Cardiology,Affiliated Hospital of Chengde Medical University from November 2020 to May 2022 were enrolled in this study.Based on the results of coronary angiography,the subjects were divided into two groups: CAD Group(n=91)and non-CAD Group(n=75).The patients with CAD were divided into low score group(≤35,n=45)and high score group(>35,n=46)according to the median of Gensini score.The serum levels of SFRP5,YKL-40 and PLR were compared between CAD group and non-CAD group,the correlation between SFRP5,YKL-40,PLR and coronary artery stenosis were compared,and the diagnostic efficacy of SFRP5,YKL-40,PLR in serum for CAD was evaluated.There was significant difference in P < 0.05.Results:1.Comparison of clinical baseline characteristics between CAD group and non-CAD group :Compared with non-CAD group,males in CAD group were 72.53% vs.45.33%(P<0.05).Smoking was 61.54% vs.32.00%(P<0.05);White blood cell count 6.70(5.35,8.08)vs.6.01(5.29,7.07,(P<0.05);Neutrophil count4.27(3.31,5.09)vs.3.75(3.04,4.34)(P<0.05);Monocyte count was 0.45(0.37,0.61)vs.0.42(0.31,0.49),(P<0.05);Total cholesterol 4.28(3.48,4.88)vs.3.93(3.21,4.50),(P<0.05);Triglyceride 1.38(1.05,2.05)vs.1.12(0.89,1.68),(P<0.05);Low density lipoprotein cholesterol 2.56(1.90,3.22)vs.2.23(1.60,2.68),(P<0.05);LA 35 vs.34(P<0.05)were higher than that of the non-CAD group,High density lipoprotein cholesterol was 1.15(0.92,1.34)vs.1.18(1.02,1.43),(P<0.05)that of the CAD group was lower in the CAD group,the difference was statistically significant(P<0.05).2.Comparison of serum SFRP5,YKL-40,PLR levels between CAD group and non-CAD group:Compared with the non-CAD group,the level of the CAD group YKL-40 7.06(4.56,11.54)vs 2.89(2.00,5.13),(P<0.05);PLR 140.15(103.47,175.14)vs 106.16(83.28,137.29),(P<0.05)were higher;SFRP56.28(3.41,9.42)vs 9.10(6.04,13.19),(P<0.05)was lower.3.Comparison of serum SFRP5,YKL-40 and PLR levels among different Gensini score groups:Compared with the low-score group,the level of the high-score group YKL-40 11.53(6.97.18.67)vs 5.30(2.73,6.98),(P<0.05);PLR 161.23(121.54,196.11),(p<0.05)vs 128.73.97.31,147.12)were higher;SFRP53.99(2.39,6.38)vs 8.99(5.85,12.44),(P<0.05),was lower.The differencewas statistically significant(P<0.05).4.The relationship between the levels of SFRP5,YKL-40,PLR and the severity of coronary artery stenosis was analyzed:The Spearman correlation analysis revealed that the levels of YKL-40,PLR were positively correlated with Gensini score,the correlation coefficient(r)was as follows: 0.486,0.481 were statistically significant(P<0.05),SFRP5 was negatively correlated with Gensini score,the correlation coefficient(r)was :-0.459,which was statistically significant(P<0.05).5.The diagnostic efficacy of serum SFRP5,YKL-40 and PLR for CAD:The ROC curve revealed the area under the SFRP5 curve of 0.714(95%CI: 0.637-0.790);the area under the YKL-40 curve of 0.806(95% CI:0.741-0.871);the area under the PLR curve of 0.711(95% CI: 0.634-0.788);Combined SFRP5,YKL-40,PLR,the area under the curve was 0.864(95%CI: 0.810.0.918),whose difference was significant(P<0.05).The optimal diagnostic cut-off values of SFRP5,YKL-40 and PLR were 3.911 ng/ml,5.570 ng/ml and 135.386 respectively.The sensitivity were 33.00%,69.20%and 59.30% separately.The specificity were 100.00%,81.30% and 74.70%separately.Combined SFRP5,YKL-40 and PLR increased the area under the ROC curve to 0.864(95% CI: 0.810.0.918,P < 0.05).6.Analysis of independent factors of CAD:The indexes of P≤0.3:sex,smoking,white blood cell,neutrophils,monocytes,total cholesterol,triglyceride,high-density lipoprotein cholesterol,low-density lipoprotein cholesterol,left atrium,SFRP5,YKL-40,PLR,hypertension,lymphocytes,total bilirubin,creatinine were included in the independent variables,were included in the independent variables.There are smoking(OR:3.607,P<0.05),triglyceride(OR:1.728,P<0.05),low-density lipoprotein cholesterol(OR:1.816,P<0.05),SFRP5(OR: 0.894,P<0.05),YKL-40(OR:1.401,P<0.05),PLR(OR:1.024,P<0.05)were the independent factors of CAD.Conclusions:1.The levels of YKL-40 and PLR in CAD patients were higher than those in non-CAD patients,but the level of SFRP5 was lower than that.It is helpful to identify the prevalence of CAD.2.The levels of SFRP5,YKL-40 and PLR were different in different Gensini score groups.YKL-40 and PLR were positively correlated with Gensini score,but SFRP5 was negatively correlated with it.The degree of coronary artery stenosis can be evaluated indirectly by the change of these levels.3.YKL-40 and PLR may be independent risk factors of CAD,and SFRP5 may be an independent protective factor of CAD.