| Background and objectiveAlong with the progress of the society and the improvement of living standards, the health level of the general population increased significantly, the expectancy of average life has extended year after year, But it has show gradual increasing in incidence of cardiovascular diseases as the increasing of cardiovascular risk factors and the development of ageing population. Many new testing and treatment technology have been applied to clinical practice as the development of medical science.The patients life quality has increased greatly at the same time the total mortality of coronary heart disease(CAD) has been decreasing. However, abnormal glucose metabolism especially in patients with type2diabetes(T2DM) with coronary heart disease (CAD) benefited little and its coronary lesions are serious and diffuse, specific mechanisms has not been completely clear. In recent years, a kind of glycoprotein is found in the serum that named Paraoxonase1(PON1), PON1closely related to the high-density lipoprotein(HDL) and the apolipoprotein A-I (apoA-I). It can also avoid low density lipoprotein(LDL) been oxidation, delaying of coronary atherosclerosis occurrence and development. In his study we committed to To study the relationship between serum paraoxonasel activity and glycosylated hemoglobin and coronary artery lesions in patients with coronary heart disease.MethodsA total of133patients suspected diagnosis with coronary artery disease,all of those was the patients bring in the Cardiology Department of our hospital from September2010to May2011. all of the patients undergoing coronary angiography and according to coronary angiography results divided into:coronary heart disease group101examples (male55and female56patients, average age62±8);32cases belong to control group (male17and female15, average age59±10). Coronary heart disease groups according to glycosylated hemoglobin levels into three groups: group A (glycated hemoglobin normal group, HbAlc<6.5%)31cases, group B (glycated hemoglobin mild-to-moderate abnormal group,6.5%<HbAlc<9%)41cases, than group C29patients (glycated hemoglobin high degree abnormal group,HbAlc≥9%). All of the patients records include age, gender, height, weight, resoures, and presence of high blood pressure, diabetes, myocardial infarction history and smoking history and so on; After check-in hospital the next morning extraction venous blood after fasting for12hours, collect fasting plasma glucose (FPG), triglycerides (TG), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), glycated hemoglobin Ale biochemical index, both by the specialist laboratory quality inspection. Serum activity of PON1was measured by spectrophotometry, coronary lesions by Gensini integral result. Compare the PON1activity and Gensini integral, PON1activity and HbAlc level analysis and correlation degree of coronary lesions. The statistical treatment:1. the study of the clinical data belongs to count material with the chi-square test;2. The measurement date which was normal distribution and homoscedasticity was compared by two sample t-test; Those was partial normal distribution was diverted by logarithm and compared by group design of the t-test; All the measurement numerical data among the three further groups of CAD which was normal distribution and homoscedasticity was compared by variance analysis, on the basis of each difference statistically significant, and then compared with t-test;3. Linear correlation was used to analyze the correlation among the lg(PONl activity) and HbAlc and Gensini score, multivariate liner regression was used to ananlyze the correlation between the multivariate and the Gensini score;4. SPSS17.7software pack was used to make statistical analysis.Result1. The general clinical features of the research object:there is not significant on the male proportion between, smoking proportion, age, body mass index (BMI), low-density lipoprotein cholesterol(LDL-C), high-density lipoprotein cholesterol (HDL-C), total cholesterol(TC) and triglycerides(TG) between the CAD group and the control group and also among the three further group of CAD (P>0.05).2. Serum activity of PON1in the coronary heart disease(2.17±0.18) reduced significantly than the control group(2.49±0.19)(P<0.01); And glycosylated hemoglobin Alc in the coronary heart disease(7.4±1.7) raised significantly than the control group(5.6±0.6)(P<0.01). Comparison among three further groups of Coronary heart disease:lg(PONl activity) in group C declined significant(P<0.01) and coronary stenosis Gensini score increased significantly(P<0.01) than group A, Serum lg(PONl activity) in group C have fallen(P<0.05) and coronary stenosis Gensini points rising(P<0.05) than group B.3. The correlation analysis shows:The logarithm of PON1liveness and glycated hemoglobin levels was negatively related(r=-0.534, P<0.01), And coronary angiography Gensini points negative correlation(r=-0.742, P<0.01). Among three further groups of the coronary heart disease:the absolute values of r values between serum PON1activity and Gensini score are gradually increasing (r values for A, B, C, group are respectively-0.812,-0.781,-0.526, P<0.01).Concolusions1. Paraoxonasel(PONl) activity in patients with coronary heart disease significantly lower than the control group, and significant negative correlation with the rising of glycosylated hemoglobin Ale levels;2. In patients with coronary heart disease and high levels of glycated haemoglobin Ale, PON1activity decline and it is closely related to the severity of coronary artery stenosis;3. The glycosylated hemoglobin levels may reduce antioxidant capacity of PON1in HDL by affect serum PON1activity and so as to promote the development of coronary atherosclerosis. |
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