| Objective: Recent studies indicated that there are intimate correlation of leptin resistance, hyperleptinemia with coronary risk factors such as obesity, hyperlipidemia, insulin resistance and diabetes mellitus, thus it has led to interest in leptin (LP) and its association with coronary heart disease (CHD). So far, we put much more attention to the relationship between leptin and CHD, but there is little research involved in how to use leptin to forecast severity extent and stability of coronary artery disease. This study will explore the relationship between plasma leptin concentration and the severity extent and stability of coronary heart disease.Methods: From April 2007 to December 2007 in our hospital, the 77 patients with positive coronary arteriography results were selected as the CHD group. There are 40 acute myocardial infarction (AMI) patients including 26 men and 14 women with the age range from 40 to 80 (66.40±11.45). There are 37 unstable angina pectoris (UAP) patients including 24 men and 13 women with the age range from 43 to 79 (60.67±11.25). The 39 patients with negative coronary arteriography results were selected as the control group, including 17 men and 22 women with the age range from 40 to 80 (66.40±11.46). Exclusion standard: Liver and renal function failure, malignant tumor, diabetes mellitus, thyroid disease, dystrophic, connective tissue disease, stroke and so on. The gender, age, blood pressure, body mass index and smoking history of all subjects were collected. Measure C reactive protein, blood fat, hepatic and renal function, tumor necrosis factor and interleukin-6 with venous blood drew on an empty stomach.Results: 1. Generally clinical characteristic:There are no significant difference among control group, unstable angina pectoris(UAP) group and acute myocardial infarction(AMI) group of age, gender, smoking, blood pressure, body mass index(BMI), triglyceride(TG), total cholesterol(TC), low density lipoprotein-cholesterol (LDL-C), high density lipoprotein-cholesterol (HLD-C) (p>0.05). 2. From control group, UAP group to AMI group, the blood LP has a tendency to increasing gradually. LP in AMI group is the highest (10.84±6.19ng/ml), in sequence from high to low, LP of two groups in order is the UAP group (8.06±5.13ng/ml), LP in control group is the lowest (3.36±2.11ng/ml). LP in AMI group and UAP group are both significantly higher than it in control group (p<0.001), and there is significant difference between UAP group and AMI group (P<0.05). 3. The comparison of the LP levels in different gender patients: The LP level of women in the control group (3.93±2.11ng/ml) is significantly higher than it of men (2.58±1.97ng/ml), and the difference of the LP levels between women and men is significant in statistics (P<0.05). The comparison of the LP levels in different gender patients among control group, UAP group and AMI group are all significantly different (P<0.05). The comparison of the LP and TNF-αamong control group, UAP group and AMI group are all significantly different (P<0.001). The comparison of the LP and IL-6 among control group, UAP group and AMI group are all significantly different (P<0.001). 4. According to the Gensini standard, the subjects were divided into three groups: Group A (≤30 score), including 29 subjects; Group B (31-90 scores), including 42 subjects; Group C (>90 scores), including 6 subjects. From Group A to Group C, the blood LP has a tendency to increasing gradually. LP level of Group A is (6.31±4.62ng/ml), Group B is (9.15±5.34ng/ml), and Group C is (16.91±4.84ng/ml).After variance analysis, the four groups have a significantly difference(P<0.05). 5. To analyze the influence factors of LP in subjects by stepwise regression analysis, make LP to be the dependent variable and BMI, TG, TC, HDL-C, LDL-C, CRP and so on which can also affect on LP to be the independent variable. It is suggested that LP and BMI, TG, TC, LDL-C CRP submit positive correlation and it is to submit negative correlation between LP and HDL-C. 6. To analyze the influence factors of CHD in subjects by logistic analysis, make CHD to be the dependent variable ,age,BMI,TG and LP are significative。Conclusion: 1. There are intimate correlation of leptin and coronary artery stability. The coronary artery stenosis is more severity, affection is more unstable, and the leptin level is higher. 2. The difference of the LP levels between male and female is significant, the LP level of female is higher than male. 3. LP was positively correlated with BMI,TC,TG,LDL-C and CRP,and negatively correlated with HDL-C.
|
PDF Full Text Request