| Objective The application value of serum CTRP1 in the clinical diagnosis of coronary heart disease was studied by detecting the concentration level of C1 q tnf-related protein-1(CTRP1)in the serum of patients with coronary heart disease.Methods Analyzed a total of 129 patients with chest pain symptoms diagnosed to coronary heart disease by coronary artery angiography(CAG)from January 2018 to October2018,at the General Hospital of Ningxia Medical University.Including 82 males and 47 females with average age of(59.7±9.5)years old.The control group consist of 43 healthy subjects including 21 males and 22 females with average age of(45.1±10.6)years which were excluded from coronary heart disease,hypertension,diabetes and other exclusion criteria.According to the clinical symptoms,myocardial enzymology markers,electrocardiogram and coronary angiography results,the coronary heart disease group was subdivided into: 10 cases of stable angina pectoris(SAP)group,4 males,6 females,average age(61.6±6.7)years old;79 cases of unstable angina pectoris(UAP),43 males and 36 females,average age(61.0±8.8)years old;40 cases of acute myocardial infarction(AMI)group,35 males and 5females,average age(56.5±10.6)years old.According to the results of CAG,38 patients with coronary artery disease were subdivided into single-vessel disease,34 with double-vessel disease,and 57 with three-vessel disease.According to the diagnostic criteria of hypertension and diabetes,the coronary heart disease group was subdivided into 33 cases of coronary heart disease alone,13 cases ofcoronary heart disease with diabetes,56 cases of coronary heart disease with hypertension,and 27 cases of coronary heart disease with diabetes and hypertension.According to the application of aspirin and statins within 24 hours before blood collection,the components of coronary heart disease were: 26 patients in the drug-free group,94 patients in the aspirin group,only 24 patients in the statin group and 68 patients in the combined drug group.The detailed general information had been recorded,such as the age,gender,body mass index(BMI),blood pressure,past history(including diabetes,hypertension),clinical medication(beta blockers,ACEI/ARB,statins,hypoglycemic agents)before blood collection.Furthermore,the results of coronary angiography and cardiac ultrasound were recorded.We also recorded biochemical indicators such as the triglyceride(TG),urea(UREA),serum creatinine(SCr),total cholesterol(TC),uric acid(UA),besides,high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C).At the same time,the serum concentration of CTRP1 was measured in all subjects before coronary angiography using enzyme-linked immunosorbent assay(ELISA).CTRP1's levels in the serum of each group were compared to discuss the function of CTRP1 and its possible worth in forecast coronary heart disease.Results The data level of CHD group in age,SBP,BMI,UA and TG was higher than that in control group,and the difference was statistically significant(p<0.05).The levels of TC,HDL-C,LDL-C,CTRP1 and LVEF% in the CHD group were lower than those in the control group,and the difference was statistically significant(p<0.05).The CHD Group and the control group were not statistically significant in gender,DBP,urea and SCR data(p>0.05).The serum CTRP1 level in UAP group was lower than that in the control group,and the difference was statistically significant(p<0.05).Serum CTRP1 levels in AMI and SAP groups were not statistically significant compared with those in the control group(p>0.05).The serumCTRP1 level in 3,1 lesions Group and 3 lesions group was lower than that in the control group,the difference was statistically significant(p<0.05),and there was no statistically significant difference between serum CTRP1 level and control group in 2 lesions Group(p>0.05).The serum CTRP1 level of UAP group was lower than that in control group,and the difference was statistically significant(p=0.02,p<0.05).The serum CTRP1 level of SAP group was lower than that in control group which was not statistically significant(p=0.968,p>0.05).The serum CTRP1 level of AMI group was lower than that in control group which was not statistically significant(p=0.068,p>0.05).There was no significant comparison of serum CTRP1 levels between different clinical subgroups(p>0.05).The serum CTRP1 level of coronary heart disease Group was lower than that in control group,the difference was statistically significant(p=0.001,p<0.05).The serum CTRP1 level of coronary heart disease group was lower than that of coronary heart disease complicated with diabetes mellitus group,the difference was statistically significant(p=0.001,p<0.05).The serum CTRP1 level of coronary heart disease group was lower than that of coronary heart disease complicated with diabetes mellitus complicated with hypertension group,and the difference was statistically significant(p=0.023,p<0.05).The serum CTRP1 level of coronary heart disease complicated with diabetic group was higher than that in coronary heart disease complicated with hypertension group,the difference was statistically significant(p=0.015,p<0.05).The serum CTRP1 level of coronary heart disease complicated with hypertension group was lower than that in control group,and the difference was statistically significant(p=0.008,p<0.05).The serum CTRP1 level of statins in patients with coronary heart disease was lower than that in the control group,the difference was statistically significant(p=0.001,p<0.05).There was no statistical significance between the serum CTRP1 level of statins-free in patients with coronary heart disease and statins in patients with coronary heart disease(p=0.093,p<0.05).There was no statistically significant difference between the serum CTRP1 levels of statins-free in patients with coronary heart disease and the control group(p=0.456,p>0.05).The serum CTRP1 level in aspirin group of coronary heart disease was lower than that in the control group(p=0.001,p<0.05).The serum CTRP1 in aspirin group of coronary heart disease was lower than that of aspirin in patients with coronary heart disease,but there was no statistically significant(p=0.319,p>0.05),and there was no statistically significant difference in serum CTRP1 level between aspirin free group and control group in coronary heart disease(p=0.265,p>0.05).The serum CTRP1 level of coronary heart disease combined with two drug groups(aspirin,statins)was lower than that in the control group,the difference was statistically significant(p=0.001,p<0.05).The serum CTRP1 level of coronary heart disease combined with two drug groups(aspirin,statins)was lower than that of aspirin group only,the difference was statistically significant(p =0.020,p<0.05).The serum CTRP1 level was positively correlated with sex,diabetes,TC,HDL-C,LDL-C(r>0,p<0.05),and serum CTRP1 level was negatively correlated with triglyceride levels(r<0,p<0.05).Age and triglyceride level are risk factors for coronary heart disease(OR>1,p<0.05),HDL and UA levels are protective factors for coronary heart disease(p<0.05).The area under the ROC curve for the diagnosis of CHD by CTRP1 is 0.680(95%CI:0.594-0.765,p<0.001).The cutoff value was 281.79 ng/ml,and the corresponding sensitivity and specificity were 77.5% and 58.1%,respectively.Conclusion The level of serum CTRP1 in patients with coronary heart disease was significantly lower than that in healthy people,but there was no significant difference in CTRP1 levels in different clinical types of coronary heart disease,and there was no significant difference in CTRP1 levels in different coronary artery lesions.Serum CTRP1 levels are associated with gender,diabetes,triglycerides,total cholesterol,high-density lipoprotein cholesterol,and low-density lipoprotein cholesterol.Serum CTRP1 levels inpatients with coronary heart disease are affected by diabetes,and diabetes may lead to elevated serum CTRP1 levels.The use of statin lipid-lowering drugs leads to a reduction in CTRP1 levels.CTRP1 has a lower diagnostic value in the clinical diagnosis of coronary heart disease,and its mechanism of action and its correlation with the severity of coronary heart disease need to be further studied. |
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