The Association Of SF, TIBC, SF/TIBC Ratio With CHD And The Severity Of Coronary Artery Stenosis

Background: Coronary heart disease( CHD) is the heart disease that cause by coronary artery atherosclerosis,which can lead to myocardial ischemia and hypoxia.About 17 million people die of cardiovascular disease each year all over the world.CHD is the leading cause of death and disease burden in the Western countries. The number of deaths account for 1/3 of the total deaths number.So far,the morbidity and mortality of our country are still in the rank of low as a Asian country.In recent30 years, the morbidity and mortality of our country have have the rising trend. In2008,The crude death rate of CHD in urban population is 91.41/1000000,and the rural population is 51.89/1000000. CHD hadcarry a heavy economic burden to our country.CHD had caused a great damagg to the Chinese health.Objective:To study the relationship of serum ferritin(SF),total iron binding capacity(TIBC),SF-to-total iron binding capacity ratio with CHD and the severity of coronary artery stenosis.Eventually explore the effect of iron overload in the process of coronary atherosclerosis.Methods: All of 185 patients suspected CHD between 2013 August-2014 August nunderwent coronary angiography. The Patients were categorized into control group and CAD group according to the results of Angiography.The Patients were categorized into control group, mild, moderate and severe degree group of coronary artery stenosis according to the Gensini score. Levels of SF, TIBC,total cholesterol(TC), triglyceride(TG),high density lipoprotein cholesterol( HDL-C),low density lipoprotein cholesterol(LDL-C),hemoglobin(HB),total protein(TP),creatinine(Cr),fas ting plasma glucose(FPG)were examined. The above data were analyzed by SPSS statistical software. ? 2 test,Kruskal-Wallis H test,t test,Student-Newman-Keuls test,Tamhane’ T2 test and Spearman’s rank correlation analysis,logistic regression analysis,ROC analysis were used in the research.:1.Univariate analysis:SF、TIBC、SF/TIBC ratio showed the significant difference among the CHD group and non-CHD control group. SF(223.88±44.08vs187.45±41.79,P=0.000),TIBC(59.86±12.03vs66.97±9.47,P=0.000)及 SF/TIBC(3.89±1.09vs2.84±0.64,P=0.000).The distributions of SF、TIBC、SF/TIBC ratio among the different severe degree group of coronary artery stenosis were significantly different(P< 0.05). The SF level mean in moderate and severe degreegroup of coronary artery stenosis were significant higher than normal coronary artery control group(P< 0.05).The SF level mean in mild, moderate degree group of coronary artery stenosis were lower than severe degree group(P< 0.05).The TIBC level mean in moderate and severe degree group of coronary artery stenosis were lower than normal coronary artery control group(P< 0.05).There were statistical difference in the each group of coronary artery stenosis.2.Multivariate analysis:logistic regression analysis showed that SF/TIBC(OR=14.142,95%CI:3.649-54.801)was independently an increased risk for CHD. SF(OR=2.833,95%CI:1.435-5.593),SF/TIBC(OR=3.254,95%CI:2.056-6.589)had statistically significant with coronary artery stenosis. TIBC(OR=0.896,95%CI:0.815-0.959)was a protective factors to coronary artery stenosis.3. Correlation analysis:Spearman’s rank correlation analysis showed that SF(r=0.535,P=0.000),SF/TIBC ratio(r=0.589,P=0.000)were positively correlate with the Gensini score.TIBC(r=-0.285,P=0.000)had a negative correlation with the Gensini score.4.ROC analysis:The AUC(95%CI) were(AUC=0.772,95%CI:0.689-0.856),(AUC=0.691,95%CI:0.607-0.775)and(AUC=0.824,95%CI:0.753-0.895)for SF,TIBC and SF/TIBC,respectively.So,after comparing the AUC with each other, the SF/TIBC was superior to single parameters.ResultsConclusion:In this study,the main conclusions are as follows:1.In this study, iron over load was found significantly positively correlated with CHD risk2.High SF was correlated with CHD and had a synergistic action with other CHD riskin the process of atherosclerosis. TIBC was a protective factors of CHD.3.The SF/TIBC was superior to single parameters in predict the severity degree of coronary artery stenosis.