Relationship Between Serum Adiponctin,C1q/TNF-Related Protein 9 And Severity Of Coronary Artery Disease

BackgroundCoronary heart disease(CHD)is a global disease that seriously endangers human health.The rise in the prevalence and mortality of CHD has led to an increase in socio-economic and medical burdens.Therefore,early diagnosis of CHD is a crucial role to improve patient prognosis and reduce the social burden.In recent years,studies have found that adipokines are closely related to the development of atherosclerosis(AS).Adiponectin(APN)is the most representative adipokines that play a role in antiatherosclerosis by improving endothelial cell function,reducing foam cell formation and inhibiting smooth muscle cell proliferation and migration.APN can also affect the development of glucose and lipid metabolism interventions in AS;C1q/tumor necrosis factor-related protein 9(CTRP9)is the closest paralog of APN.They belong to the CTRPs protein superfamily and have similar biological functions.At present,the expression of CTRP9 in CHD is controversial,and there are few studies on the combined detection of APN and CTRP9 to predict the severity of coronary heart disease.ObjectiveTo study the expression of serum CTRP9 and APN in patients with CHD,and to explore the relationship between the levels of serum APN and CTRP 9 and the severity of coronary artery disease,and provide a new target for the diagnosis and treatment of coronary heart disease.MethodsA total of 114 patients who underwent coronary angiography in the cardiology department of the First Affiliated Hospital of Xinxiang Medical University from March 2018 to September 2018 were randomly selected.According to the angiographic results,they were divided into coronary heart disease group(CHD)(86 cases)and control group(28 cases).According to the number of coronary stenosis vessel,the patients were divided into single vessel lesion(21 cases),double vessel lesion(25 cases)and multi-vessel lesion group(40 cases).The degree of coronary artery disease was scored by Gensini scoring system.The CHD group were divided into group of< 30 scores(15 cases),30-90 scores(44 cases)and > 90 scores(27 cases).Serum APN and CTRP9 levels were detected by ELISA,the correlation between serum APN and CTRP9 levels and severity of coronary artery disease was analyzed.Results1.There were no significant differences in age,gender,diabetes,family history of coronary heart disease,statin medication history,waist circumference,Hcy,TC,LDL and GLU between CHD group and control group(P>0.05).Hypertension,smoking,BMI,TG and Gensini scores in the CHD group were higher than those in the control group(P<0.05),and HDL,APN and CTRP9 were lower than those in the control group(P<0.05).2.Univariate Logistic regression analysis showed that hypertension,smoking history,BMI,TG,HDL,APN,CTRP9 were related to coronary heart disease.Multivariate Logistic regression analysis showed that APN and CTRP9 were the independent protective factors of CHD.3.The levels of serum APN in control group,single vessel lesion group,double vessel lesion group and multiple vessel lesion group decreased in turn with statistical significance(P <0.05);the levels of serum CTRP9 in single vessel and double vessel lesion group were significantly lower than those in control group(P <0.05);the levels of CTRP9 in multiple vessel lesion group were lower than those in control group,single vessel and double vessel lesion group(P<0.05).4.The levels of serum APN and CTRP9 in the group which Gensini score <30 and 30~90 group was lower than the control group(P<0.05);The levels of serum APN and CTRP9 in the group which Gensini score >90 was lower than the control group,score <30 group and 30~90 group(P<0.05).5.The levels of serum APN and CTRP9 was negatively correlated with Gensini score(r=-0.611,P<0.001),(r=-0.527,P<0.001).6.Serum APN was positively correlated with CTRP9(r=0.384,P< 0.01).7.AUC was 0.849(95%CI = 0.777~0.920,sensitinity 76.7%,specificity 80.5%)for APN to judge coronary multi-vessel disease,AUC was 0.778(95%CI = 0.693~0.862,sensitinity 53.4%,specificity 90.2%)for CTRP9 to judge coronary multi-vessel disease.Conclusion1.The levels of serum APN and CTRP9 in CHD group decreased compared with the control group,and serum APN and CTRP9 levels were negatively correlated with the severity of coronary artery disease,which could be used as an effective indicator for the severity of coronary artery disease.2.Serum APN is positively correlated with CTRP9.3.Serum APN and CTRP9 have predictive value for coronary multivessel disease,and the predictive effect of serum APN is better than CTRP9.