Correlative Study On The Relationship Between Serum OPG And SRANKL And Coronary Heart Disease

BackgroundsThe incidence of coronary heart disease (CHD) increased year by year. It has become a serious harm to human health.It has important value to assess the risk factors for CHD in predicting the accurrence of cardiovascular events. osteoprotegerin (OPG) is a new member of tumor necrosis factor(TNF) receptor family.Recent study found that, it is an important regulator of vascular and related with vascular calcification and atherosclerosis(AS), who may play an important role in the the occurrence and developing of CHD. Vascular system is the source of receptor activator of nuclear factorκB (RANKL), who is also the target of its regulation. RANKL arise from T lymphocytes, endothelial cells, smooth muscle cells and monocytes, who are activated by inflammation. By varied channels,it makes mononuclear cells to produce matrix metalloproteinase 9 (MMP-9), endothelial cell proliferation, smooth muscle cell differentiation, blood vessel wall matrix calcification, bone protein synthesis, etc. In these ways, RANKL cause harm to the blood vessels.At present, research on serum OPG and receptor activator of soluble nuclear factor-κB ligand (sRANKL) with CHD is less. Some research results show that the level of serum OPG in patients with CHD is higher, but the level of sRANKL is on the contrary.they may be involved in the accurrence and development of coronary CHD.ObjectiveTo observe the serum OPG and sRANKL levels in patients with CHD, and to analyze the relationship between those parameters and unstablility of coronary artery lesion and the degree of coronary stenosis.Methods88 patients visited the Department of Cardiology of the First Affiliated Hospital of Zhengzhou University from February 2009 to June 2009 were included. In accordance with the clinical manifestation,patients were divided into 4 groups:17 patients with stable angina pectoris (SAP) cases,36 patients with unstable angina pectoris (UAP), as well as 8 patients with acute myocardial infarction (AMI),and 27 patients as control subjects. All the subjects underwent coronary angiography. Except for acute myocardial infarction in patients with coronary heart disease, the subjects were divided into 3 groups according to the results of coronary angiography: single-vessel group (9 cases), double-vessel group (17cases), more than three-vessel group (27 cases). the serum concentrations of OPG and sRANKL from the elbow vein were determined by ELISA. And to analyse the correlation between serum OPG and sRANKL.Results1. In accordance with the clinical manifestation, serum levels of OPG and sRANKL were not different in AMI and UAP groups(P>0.05), but the serum level of OPG was higher and sRANKL was lower in AMI and UAP groups compared with SAP group and control subjects(P<0.05).And the serum level of OPG was higher and sRANKL was lower in SAP group compared with control subject(P<0.05).2. According to the degree of coronary artery disease, serum OPG levels was significantly higher(P<0.05) compared with normal control group. With the increase of lesions in branches of Coronary artery, the level of serum OPG gradually increased(P<0.05), serum sRANKL levels was significantly lower and the level of serum sRANKL gradually decreased(P>0.05)3. Correlation analysis showed that, The level of serum OPG was negatively correlated with the sRANKL level.Conclusions1. In patients with CHD, serum OPG level was higher and serum sRANKL level was lower, which may be important in prediction of CHD.2. The extent of serum OPG and sRANKL alterations was negatively correlated with each other. Increased serum levels of OPG and decreased serum levels of sRANKL reflected acute inflammory response tomyocardial ischemia and is useful to define the unstabitity of plaque of coronary arteries in acute coronary syndrome(ACS) patients.3. With the increase of lesions in branches of Coronary artery, the serum OPG level some extent reflects the severity of coronary artery disease.