| Objectives:The aim of this study was to make clear the incidence of coronary atherosclerosis through coronary CTA and the distribution of routine biochemical markers in asymptomatic non-diabetic population, analyze the correlation between them and find out the best biomarker for predicting the occurrence of subclinical lesions. To evaluate the diagnostic efficacy of different risk evaluation system on the occurrence and development of coronary atherosclerosis in this population and to understand the value of biomarkers for improving stratification by studying the difference between traditional risk stratification and the real extent of atherosclerosis, thus to find simple method for the early prevention of coronary heart disease (CHD).Material and Methods:Six hundred asymptomatic health examination subjects without diabetes who underwent coronary CT angiography and conventional biochemical testing in our hospital were selected. Observed the incidence of coronary atherosclerosis and the distribution of biomarkers related to-CHD, correlation between serum markers levels and atherosclerosis indexes by CT were analyzed to explore the predictive value for the occurrence and development of coronary artery lesions. The diagnostic performance of FRS, CMCS and ASCVD risk assessment system for the presence and severity of coronary atherosclerosis were assessed in all subjects. We compared differences of the actual degree of atherosclerosis and the levels of specific biomarkers among low, moderate and high risk stratification by FRS as to understand the ability of traditional risk score to identify individuals at high risk and the value of biochemical markers to improve stratification.Results:(1)56.2% subjects were found plaque in main branch of coronary artery by CT and 6.5% were diagnosed as coronary heart disease (luminal stenosis≥50%). There was no statistically significant difference of ApoA1 levels between atherosclerosis group and control group. Some of biomarkers which had statistically significant difference between the two groups showed the weak correlation with CACS, SIS and SSS(r<0.3). The receiver operating characteristic curve showed that ApoB and HCY was respectively the best biochemical indicators to predict the presence of plaque and CHD. (2)ASCVD risk score had optimal diagnostic value for subclinical coronary atherosclerosis in non-diabetic women and was equivalent with FRS in men. Three kinds of risk score were lack of recognition ability for CHD in women; FRS was the best risk score for distinguishing CHD in men. There were weak correlations between atherosclerosis indexes and the score which mentioned above (r<0.4). There were significant difference between low risk group with moderate and high risk group in terms of the incidence of coronary atherosclerosis and CHD, while there was no statistical difference between the moderate and high risk group. Interlayer comparison of each atherosclerosis index also basically showed the trend. Levels of LDL-C and the ratio of ApoB/ApoAl elevated along with the increase of risk stratification and the interlayer distribution of ApoB, SUA, TG and HCY were not all the same.Conclusion:Prevalence of coronary atherosclerosis in asymptomatic population without diabetes cannot be ignored. Although the traditional risk assessment systems have better ability to identify the existence of plaque in coronary artery, they show weak relationship with the severity of concrete lesions. Diverse biomarkers can reflect characteristics in different stages of coronary atherosclerosis development. However, the role of ApoAl in subclinical atherosclerosis was not evident. Combined with risk score and the specific biomarkers may help to distinguish high risk individuals from moderate more accurately in this population. |
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