Change Of Serum YKL-40 Level In Patients With Coronary Heart Disease Combined Diabetes And Its Correlation With The Severity Of Coronary Artery Lesion

BackgroundCoronary artery disease is dangerous to human health and life, it is a common and frequently-occurring disease. Diabetes is a serious risk to coronary heart disease. The main risk factors for coronary heart disease are high blood pressure, dyslipidemia, smoking. Clinically found that the patients with coronary heart disease combined diabetes mellitus, their coronary artery has diffuse, narrow degree and other badly characteristic. The coronary artery lesion of coronary heart disease combined diabetes is often extensive and continuous, and it is related to the level of the blood glucose and the duration of the diabetes.Diabetes cause atherosclerosis has complex causes, including elevated blood pressure, blood lipid disorders, endothelial damaged, platelet function abnormal, high condensation state and so on, these factors are the same with non diabetic patients. But the long-term high blood glucose lead to the increase of advanced glycation end product(AGE) and the increase of AGE intensify oxidative stress and inflammatory reaction. This is the main reason for coronary heart disease patients with diabetes coronary lesions have more serious. Previous studies have found that a variety of inflammation markers such as c-reactive protein (CRP), interleukin 6 (IL-6), tumor necrosis factor-α(TNF-α) are increases in coronary heart disease and diabetes patients serum. New research found that YKL-40 (chitinase-3 like-1 protein) is a kind of inflammation factors, it is increased in the serum of coronary heart disease and diabetes patients. Some research found that YKL-40 are expressed in atherosclerotic plaque, this proofed that YKL-40 may be involved in the atherosclerotic plaque formation of coronary heart disease patients with diabetes.ObjectiveThis study test the serum YKL-40 level of coronary heart disease patients with diabetes mellitus, discusses the role of YKL-40 in the coronary heart disease with diabetes mellitus patients. And combined with the coronary angiography (CAG) results, count the number of blood vessels lesion. The degree of coronary artery stenosis was assessed by Gensini score. To investigate the serum levels of YKL-40 in patients with coronary heart disease combined diabetes mellitus and its relationship with the severity of coronary artery lesion.MethodsEighty eight patients were analyzed from October 2010 to May 2011 in our hospital. Coronary angiography were detected for all patients. According to coronary angiography results combined with a clinical history, all the patients are divided into three groups:26 cases of control group:coronary angiography negative; 29 cases of simple coronary heart disease group:coronary angiography results at least one coronary artery lumen diameter stenosis> 50%, and their have a recent typical angina symptoms; 33 case of coronary heart disease with diabetes group:their have a recent typical angina symptoms and coronary angiography results show at least one coronary artery lumen diameter stenosis> 50%; And they are diagnosed with diabetes according to diabetes diagnosis standard.All the participants are extracted venous blood 4 ml in the next morning after admission, rest for 30 minutes in room temperature, centrifugal separation serum, and put it into -80℃refrigerator save, one-time to test. The degree of coronary artery stenosis was assessed by Gensini score.Use SPSS 17.0 software package to do statistical analysis, measurement data to mean±standard deviation said, the comparison between different groups use Oneway ANOVA; The correlation between the variable comparison use Pearson correlation analysis. To P<0.05 for difference have statistical significance.ResultsCompared to normal control group, the level of serum YKL-40 was significantly increased in the coronary heart disease combined diabetes group and simple coronary heart disease group (P<0.01). Coronary heart disease combined diabetes group serum YKL-40 level higher than simple coronary heart disease group, the concentration was markedly increased (P<0.05).The serum level of YKL-40 was positively correlated with Gensini score (r =0.655, P<0.01) in coronary heart disease with diabetes group. Simple coronary heart disease group serum YKL-40 level and Gensini score has some positive correlation, but not reach significant difference (r=0.354, P> 0.05).The serum level of YKL-40 was positively correlated with HbAlc (r=0.475, P <0.05) in coronary heart disease with diabetes group. Simple coronary heart disease group serum YKL-40 level was not significantly associated with HbAlc (r=0.177, P >0.05).Conclusions1. Compared to the normal control group and simple coronary heart disease group, the level of serum YKL-40 was significantly increased in the coronary heart disease combined diabetes group. The coronary heart disease combined diabetes patients serum YKL-40 level is positively correlated with HbA1c level.2. The coronary heart disease combined diabetes patients serum YKL-40 level is closely related to the severity of coronary artery disease, suggesting that YKL-40 can be used as new inflammatory makers that indicate coronary artery stenosis.