| Objective：To explore the correlations between the levels of serumapolipoprotein AI（apoAI）and apolipoprotein B（apoB）and the ratio ofapoB/apoAI and coronary heart disease（CHD）and the severity of coronaryartery lesions in an aged populationMethods：A total of1788inpatients who were at and above60yearsold suspected/diagnosed as CHD in the second affiliated hospital ofChongqing medical university from October2008to April2011acceptedcoronary angiography and detected their blood lipids were analyzedretrospectively. According to the results of coronary angiography，thepatients were divided into CHD group(nï¼1233)and control group(nï¼555).The CHD patients were divided into single-vessel disease group，double-vessel disease group and multi-vessel disease group according tothe number of branches suffered coronary artery. According to Gensiniscore，the CHD patients were divided into mild disease group(0<Gensiniscore≤12)， moderate disease group(12<Gensini score<32)and severedisease group(Gensini score≥32).The levels of serumtriglycerides(TG),total cholesterol(TC), high-density lipoprotein cholesterol(HDL-C), low-density lipoprotein cholesterol(LDL-C), apoAI,apoB and the ratio of apoB/apoAI were compared between in the CHDgroup and those in the control group, also these parameters were comparedamong different number of coronary lesion subgroups and among differentseverity of coronary lesion subgroups. Through Spearman correlationanalysis, the correlations between the indexs of TG, TC, HDL-C, LDL-C,apoAI, apoB, apoB/apoAI and the number of coronary artery lesion wereanalyzed, also the correlations between these indexs and the severity ofcoronary lesion were analyzed. And finally the independent risk factors ofCHD were screened by multi-factor logistic regression analysis.Results：1.The age and the percentages of male, smoking,hypertension and diabetes mellitus were significantly higher in the CHDgroup than those in the control group(all P<0.001),the BMI was alsosignificantly higher in the CHD group than that in the controlgroup(P<0.05).2.The levels of HDL-C and apoAI in the CHD group weresignificantly lower than those in the control group(all P<0.001),the level ofapoB and the ratio of apoB/apoAI were significantly higher in the CHDgroup compared with those in the control group(all P<0.001),there were nostatistically differences in the levels of TG, TC or LDL-C between the CHDgroup and the control group(all P>0.05).3. The levels of HDL-C, apoAIand apoB and the ratio of apoB/apoAI were statistically different indifferent number of coronary artery lesions subgroups in patients with CHD(all P<0.001),the number of coronary artery lesion was increased withthe increased level of apoB and ratio of apoB/apoAI(all P<0.001), the levelof apoAI was significantly lower in the multi-branch disese groupcompared with that in the double-vessel disease group and that in thesingle-vessel disease group[1.20(0.32)g/L vs1.27(0.33)g/L vs1.28(0.33)g/L, both P<0.001), the level of apoAI was significantly lower inthe double-vessel disease group compared with that in the single-vesseldisease group[1.27(0.33)g/Lvs1.28(0.33)g/L， P<0.0167],the level ofHDL-C was significantly lower in the multi-vessel disease group comparedwith that in the double-vessel disease group and that in the single-vesseldisease group(P<0.01, P<0.001,respectively), there was no statisticallydifference between the double-vessel disease group and the single-vesseldisease group(P>0.05).there were no statistically differences in the levelsof TG, TC or LDL-C among different number of coronary artery lesionssubgroups in patients with CHD(all P>0.05).4. The levels of HDL-C,apoAI and apoB and the ratio of apoB/apoAI were statistically different indifferent severity of coronary artery lesions subgroups in patients withCHD(all P<0.001), the severity of coronary artery lesion was aggravatedwith the increased level of apoB and ratio of apoB/apoAI(all P<0.001), thelevel of apoAI was significantly lower in the severe lesion group than thatin the moderate lesion group and that in the mild lesion group [1.20(0.32)g/L vs1.27(0.34)g/L vs1.29(0.31)g/L, both P<0.001], there was no statistically difference between the moderate lesion group and the mildlesion group[1.27(0.34)g/L vs1.29(0.31)g/L,P>0.0167],the level of HDL-Cwas significantly lower in the severe lesion group compared with that in themoderate lesion group and that in the mild lesion group (P<0.01,P<0.001respectively),there was no statistically difference between the moderatelesion group and the mild lesion group[1.11(0.33)mmol/L vs1.14(0.34)mmol/L, P>0.0167].There were no statistically differences in thelevels of TG, TC or LDL-C among different severity of coronary arterylesions subgroups in patients with CHD(all P>0.05).5.The levels of apoAIand HDL-C were significantly negatively correlated with the number andseverity of coronary artery stenosis(r_s=-0.178, P<0.001; r_s=-0.211, P<0.001;r_s=-0.130, P<0.001; r_s=-0.139, P<0.001),the level of apoB and the ratio ofapoB/apoAI were significantly positively correlated with the number andseverity of coronary artery stenosis(r_s=0.349,P<0.001; r_s=0.381,P<0.001;r_s=0.403,P<0.001; r_s=0.450, P<0.001),there were no correlations betweenthe levels of TG, TC or LDL-C and the number and severity of coronaryartery stenosis(all P>0.05).6.The multi-factor logistic regression analysisshowed that age, apoB, apoB/apoAI, male, smoking, hypertension, diabetesmellitus were independent risk factors for CHD, all these parameters weresignificantly positively correlated with the occurrence of coronary arterydisease(β value was0.037,1.528,0.878,0.310,0.969,0.416, and0.763,respectively, P <0.001~0.05). Conclusion：1. The serum level of apoB and the ratio of apoB/apoAIare still significantly positively correlated with the number and severity ofcoronary artery lesions although there are no statistically differences in thelevels of TG, TC or LDL-C between the CHD group and the control group;the serum levels of HDL-C and apoAI are significantly negativelycorrelated with the number and severity of coronary artery lesions, but thecorrelation of between apoAI and CHD is slightly strong than that ofHDL-C; the levels of HDL-C, apoAI and apoB and the ratio of apoB/apoAIcan reflect the severity of coronary artery lesions in an aged population.2.ApoAI, apoB and apoB/apoAI ratio are superior to any traditional lipidindex in the predictive value of CHD.3. ApoB and apoB/apoAI ratio maybe independent risk factors for CHD in an aged population and apoB,apoB/apoAI ratio, aging, male, smoking, hypertension and diabetesmellitus jointly promote the occurrence of CHD.4. The serum levels ofapoA-I and apoB should be as a routine testing project and the ratio ofapoB/apoAI should be calculated in current clinical practice so that theclinical doctors can better evaluate the risk of CHD and predict the severityof coronary artery lesions. |
