Correlation Analysis Between Metabolites And Coronary Heart Disease

Objective:In this study,the plasma metabolite levels of two groups of subjects(normal control group and coronary heart disease group)were compared to explore the relationship between metabolite levels and coronary heart disease,and to explore the preliminary research on the pathogenesis of atherosclerosis.Methods:(1)Study subjects: From September 2018 to March 2019,280 patients with chest pain were reported to be hospitalized in the Department of Cardiology,Second Affiliated Hospital of Dalian Medical University.There were 153 males and127 females,aged from 36 to 78 years old,with an average age of(55.94±8.77)years.(2)Biochemical examination: All of the patients in the hospital the next morning on an empty stomach was more than 8 hours in venous blood,all the specimens sent to the hospital clinical laboratory,routine inspection items include: routine blood,blood coagulation routine,biochemical,renal function,electrolyte,liver proBNP,myocardial marker,total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C),thyroid function,tumor markers,etc.(3)Metabolic examination: All patients underwent elbow venous blood for more than 8 hours in the early morning of the next morning.Metabolic group was performed by ultra performance liquid chromatography coupled with electrospray ionization quadrupole time-of-flight mass spectrometry(UPLC-ESI-QTOF MS).According to the analysis,a total of 58 indicators of 23 amino acids and 35 carnitines were obtained.(4)All the selected patients underwent coronary angiography upon admission,and were divided into two groups according to the angiographic results:(1)Coronary heart disease group: A total of 168 cases were included,including 107 males and 61 females,with an average age of(56.76±8.69)years.(2)The control group:(in the same period,suspected coronary heart disease,patients who underwent coronary angiography except for coronary heart disease after admission and no major life events occurred in the near future),a total of 112 cases were included,including 52 males and60 females,with an average age of(54.71±8.78)years old.Plasma metabolites from the coronary heart disease group and the control group were analyzed to find plasma metabolites associated with coronary heart disease.The obtained data were analyzed and processed using SPSS 24.0 statistical software.Results:1.Compared with the control group,the smoking,hypertension,diabetes,TG,BMI levels were significantly increased in the coronary heart disease group,and the HDLC level was significantly decreased,the difference was statistically significant(P < 0.05);in age,drinking There was no significant difference in history,family history of coronary heart disease,TC,LDLC,and drinking history(P > 0.05).2.Compared with the control group,in the related metabolites of the coronary heart disease group: homocysteine(Hcy),leucine(Leu),valine(Val),pentenoylcarnitine,myristyl diacylcarnitine,The levels of octadecanoylcarnitine and3-OH octadecenoylcarnitine were significantly increased,and the level of tryptophan(Trp)was significantly decreased.The difference was statistically significant(P < 0.05).The remaining alanine There were no significant differences in 50 metabolic indexes such as arginine,asparagine,aspartic acid,citrulline and cysteine(P > 0.05).3.ROC curve analysis of eight metabolic indicators of Hcy,Leu,Val,Trp,pentenoylcarnitine,myristyl diacylcarnitine,octadecanoylcarnitine and 3-OH octadecenoyl carnitine for the diagnosis of coronary heart disease Sensitivity and specificity,it was found that Hcy(AUC = 0.714),myristyl diacylcarnitine(AUC =0.757)and Val(AUC = 0.883)have reference value for the diagnosis of coronary heart disease,and the reference value of Val for coronary heart disease diagnosis maximum.Trp(AUC = 0.664),Leu(AUC = 0.594),pentenoylcarnitine(AUC = 0.639),octadecanoylcarnitine(AUC = 0.600),3-OH octadecenoylcarnitine(AUC = 0.674)There is no reference value for the diagnosis of coronary heart disease.The area under the curve(AUC)of Hcy in the diagnosis of coronary heart disease was 0.714,the 95%confidence interval was 0.653-0.775,P < 0.01;when the Hcy concentration was >8.19umol/L,the sensitivity to diagnose coronary heart disease was: 85%,the specificity is: 50%.The area under the curve(AUC)of myristyl diacylcarnitine in the diagnosis of coronary heart disease was 0.757,the 95% confidence interval was:0.700-0.814,P < 0.01;when the concentration of myristyl diacylcarnitine was >0.02umol/L At the time,the sensitivity of diagnosis of coronary heart disease was:49%,and the specificity was: 85%.The area under the curve(AUC)of Val in the diagnosis of coronary heart disease was 0.883,the 95% confidence interval was:0.845-0.920,P < 0.01;when the Val concentration was >116.85umol/L,the sensitivity to diagnose coronary heart disease was: 75%,the specificity is: 86%.4.Multiple linear regression analysis was performed with or without coronary heart disease as the dependent variable,diabetes,hypertension,smoking history,family history of coronary heart disease,BMI,Hcy,Leu,Val,Trp,and LDL-C.Results: BMI,Val and Hcy are independent risk factors for the occurrence of coronary heart disease(OR values 1.452,1.076,1.364,respectively).Leu and Trp did not enter the equation,suggesting that Leu and Trp are risk factors for coronary heart disease,but they are not independent risk factors.Conclusions: 1.The levels of plasma Hcy,Leu,Val,Trp,pentenoylcarnitine,myristyl diacylcarnitine,octadecanoylcarnitine and 3-OH octadecenoyl carnitine were significantly correlated with the occurrence of coronary heart disease;Among them,Hcy and Val were positively correlated with the occurrence of coronary heart disease;2,Hcy,myristyl diacylcarnitine and Val have a reference value for the diagnosis of coronary heart disease,of which Val has the greatest diagnostic value;3,BMI,Val,Hcy are independent risk factors affecting the occurrence of coronary heart disease,Leu,Trp is a risk factor for coronary heart disease,but not an independent risk factor.