| Objective: Coronary Atherosclerotic Heart Disease is a kind of heart disease because coronary atherosclerotic lead to coronary stenosis or emphraxis,or(and) because functionality changes of coronary ,at last lead to myocardial ischemia hypoxia or necrosis, which is called coronary heart disease.Atherosclerosis is a complex inflammatory disease,involving many physiological mexhanisms,in which immunologic,metabolic,genetic,and environmental factors interact. Visfatin is a new kind of fat factor which discovered rencently,many researches in and abroad discovered visfatin closely related with glucose metabolism, formation of the vulnerablemottling, the formation of the new blood vesse,l the blood vessel inflammation, the endothelium dysfunction, the hyperplasia of the vascular smoothmuscle cell and so on, while these factors relate closely with atherosclerosis. Statins are a widely used lipid-reduction drug in clinic.A growing body of evidence demonstrates that statins possess an additional cardiovascular protective activity in addition to their lipid-reduction capacity, including direct beneficial effects on endothelial function, anti-inflammatory effects, and inhibition of platelet aggregation and so on. Now,there are related researches about taking medium dosage of stains in midst or long term can improve the function of blood vessel endothelium,but there is rare research about effect of taking large dose of atorvastatin on endothelial function and visfatin in short time. This study was designed to observe after taking large dose of atrovarstatin 12 hours,then performed oral glucose tolerant test (OGTT),measured the changes of plasma visfatin level and the endothelium-dependent arterial dilation .to discuss effect of taking large dose of atorvastatin on endothelial function and visfatin after acute glucose load in short time ,in order to provide a theoretical basis for clinical medicine. Methods: 30 healthy staffs were recruited as normal control group(16males and 14females), with average age of (53.87±7.18) years. 60 patients with coronary heart disease(36males and 24females), with average age of (50.4±11.3) years,which had been diagnosed with coronary angiography coronary artery disease (According to internationally accepted method for evaluation of coronary artery diameter stenosis, who were≥50% stenosis as CHD).The patients with coronary heart disease were divided into two groups:30 patients only took OGTT as OGTT group, with average age of (50.6±5.76) years,the other 30 patients took 80mg Atorvastatin before took OGTT 12h as OGTT+ Atorvastatin group, with average age of (49.8±4.13) years. All subjects had excluded that:⑴Metabolic disease(diabetes, hyperlipemia, thyropathy);(2) Hypertensive disease;(3)Severe hepatic and kidney disease, blood disease, infectious diseases, surgical trauma, malignant tumour(4) Applicating anti-inflammatory drugs,hormone,lipid-reduction drug;(5)Valvular disease of the heart;The age, sex, BMI, blood-lipid,blood glucose and blood pressure showed no difference among three groups. Detection of the first day after admission in patients with fasting blood glucose and visfatin,and calculate endothelium-dependent vasodilatation(FMD) of brachial artery. All subjects performed oral glucose tolerant test (OGTT) after fast 12h. Detect the level of blood glucose,visfatin and FMD at fast and 2h.Results:1 Comparision of baseline visfatin level with control group,OGTT group and OGTT+ Atorvastatin group were significantly higher(55.26±3.12 vs 21.13±2.37ug/L P<0.05; 55.29±3.45 vs 21.13±2.37ug/L P<0.05), baseline FMD were significantly lower (6.21±1.03 vs 13.76±1.32% P<0.05; 5.95±1.03 vs13.76±1.32% P<0.05).2 Compare with OGTT group, FMD in 0h and 2h of OGTT+ Atorvastatin group were significantly higher(11.92±1.04vs 6.20±0.97% P<0.05; 7.9±1.02vs 3.33±0.94% P<0.05),the baseline value had no difference(5.95±1.03vs 6.21±1.03% P>0.05).3 Compare with OGTT group, visfatin in 0h and 2h of OGTT+ Atorvastatin group were significantly lower(34.65±3.80 vs 55.33±3.24ug/L P<0.05; 39.75±3.93 vs 66.21±3.99ug/L P<0.05),the baseline value had no difference(55.29±3.45vs 55.26±3.12ug/L P>0.05).4 OGTT group and OGTT+ Atorvastatin group 2h plasma visfatin level were significantly higher than fast(66.21±3.99 vs 55.33±3.24ug/L P<0.05; 39.75±3.93 vs 34.65±3.80ug/L P<0.01),but FMD were significantly lower(3.33±0.94vs 6.20±0.97% P<0.05; 7.9±1.02vs11.92±1.04% P<0.05).5 In OGTT group and OGTT+ Atorvastatin group, blood glucose were positive related to visfatin level in 2h(r=0.887,r=0.831 P<0.05), blood glucose were negatively related to FMD(r=-0.764,r=-0.-681 P<0.05).Conclusion:1 Acute glucose load rapidly suppresses endothelium-dependent arterial dilation,and increase the plasma visfatin level of patients with coronary heart disease.2 After taking OGTT 2h ,blood glucose were positive related to visfatin level ,blood glucose were negatively related to FMD in patients with coronary heart disease.3 Taking large dose of atorvastatin in short time also can improve endothelium-dependent arterial dilation during acute glucose load,depress plasma visfatin level.
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