First Exploration Of The Relationship Between Serum Vitamin D Levels And The Stability Of Coronary Plaques

Objective:To analysis the relationship between sereum levels of 25-hydroxyvitamin D [25(OH)D] and properties of coronary plaques with dual-source computed tomography(DSCT).To investigate the relationship between serum levels of 25(OH)D and the factors indicating coronary plaques unstablility [matrix metalloproteinases-2(MMP-2)and lectin-like oxidized low-density lipoprotein receptor-1(LOX-1)].Method:Patients,having symptoms of chest congestion or chest pain and admitted to Tianjin Chest Hospital from 2017-02 to 2017-07,were studied.201 patients,including the control plaque group(n=77),stable plaque group(n=59)and high-risk plaque group(n=69).Patients without coronary plaques were enrolled into the control group.Plaques with CT number >130 Hounsfield Unit(HU)and diameter >3mm were referred to stable plaques.Plaques including all features of low attenuation(<30 HU),positive remodeling(remodeling index>1.1)and napkin-ring sign were referred to high-risk plaques.Related basic clinical data of patients were collected later.Serum levels of 25(OH)D,MMP-2 and LOX-1 were measured by enzyme-linked immunosorbent assay.Result:1.There were no significant differences found among 3 groups in basic clinical data(P>0.05),icluding age,sex,BMI,TC,TG,LDL-C,HDL-C,family history,history of hypertension,diabetes and smoking,as well as the medications on admission,including antiplatelet drugs,angiotensin converting enzyme inhibitor/angiotensin converting enzyme receptor antagonist(ACEI/ARB),beta blockers,calcium antagonists,lipid-lowering medicines.2.No significant differences were discovered between the stable plaque group and the high-risk plaque group in the main vessel containing coronary lesions,stenosis degree of coronary induced by plaques,and numbers of vessels existing coronary lesions(P>0.05).3.Serum levels of 25(OH)D in the high-risk plaque group were lower than that in the control group and the stable plaque group(P<0.01),and that in the stable plaque group were lower than that in the control group(P<0.01).Serum levels of MMP-2 and LOX-1 in the high-risk plaque group were higher than the control group and the stable plaque group(P<0.01).And serum levels of MMP-2 in the stable plaque group were higher than the control group(P<0.05),that of LOX-1 in the stable plaque group were higher than the control group(P<0.01).4.Pearson linear correlation analysis showed that serum levels of 25(OH)D were negatively related to that of MMP-2(r=-0.589,P< 0.001)and LOX-1(r=-0.615,P<0.001).While serum levels of MMP-2 were positively associated with that of LOX-1(r=0.536,P<0.001).5.Ordinal regression analysis revealed that serum levels of 25(OH)D(OR=0.964,95%CI:0.932~0.997,P=0.032),MMP-2(OR=1.093,95%CI:1.006~1.189,P=0.037)and LOX-1(OR=1.024,95%CI:1.001~1.050,P=0.048)were independent factors for the stability of coronary artery plaques.And 25(OH)D(?=-0.037,OR=0.964)was a protective factor,MMP-2(?=0.089,OR=1.093)and LOX-1(?=0.024,OR=1,024)were risk factors.Conclusion: 1.Serum levels of 25(OH)D in patents having high-risk plaque were significantly lower than that in patients wihout coronary plaques and patients with stable plaques.And that in patients with coronary stable plaques were significantly lower than that in patients wihout coronary plaques.2.Serum levels of 25(OH)D were negatively associated with the factors indicating coronary plaques unstablility(MMP-2 and LOX-1).3.In patients without acute myocardial infarction,lower levels of serum 25(OH)D predicted unstable coronary plaques,and the serum level of 25(OH)D might be a protective factor for the stablity of coronary plaques.It might be a new idea of predicting acute cadiovacular event.