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Study on Relationship between Serum Level of Visfatin and Coronary Heart Disease

Author: ZhouGuiJian
Tutor: ZhangNingRu
School:
Course: Internal Medicine
Keywords: visfatin Coronary heart disease matrix metalloproteinase-9 high-sensitivity C-reactive protein
CLC: R541.4
Type: Master's thesis
Year: 2011
Downloads: 42
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Abstract


Background: Adipose tissue is currently considered as a hormonally active system inthe control of metabolism and not only as a store of excess energy. It’s found thatadipocytes produce and secrete a variety of biologically active molecules,conceptualized as adipocytokines. Visfatin is a newly discovered adipocytokinsynthesized mainly by visceral fat. Its structure is the same as pre-B-cellcloning-enhancing factor. Visfatin can imitate insulin actions, facilitate accumulationand synthesis of adipose tissue, affect endothelial function, enhance the expression ofadhension molecules, modulate maturation of vascular smooth muscle, and participatein atherosclerosis. Therefore visfatin may be a new bond linking glucose and lipidmetabolism disorders and cardiovascular diseases.Objective: The objective of this study is to determine the levels of serum visfatin,matrix metalloproteinase-9(MMP-9) and high-sensitivity C-reactive protein(hs-CRP)in patients with coronary heart disease (CHD), compare their relationships, analysethe correlation between serum visfatin level and the degree of coronary arterialstenosis and plaque stability, and investigate the mechanism of visfatin in coronaryheart disease.Methods: All subjects were enrolled from inpatients who underwent coronaryangiography. We studied total of88patients. These included62patients with CHD,26controls. They were divided into three groups according to clinical history: normalcontrol group, stable angina pectoris(SAP)group, acute coronary syndrome(ACS)group. They were divided into four groups according to the number of coronary arterystenosis: normal control group, single vessel disease group, double vessel diseasegroup and multi vessel disease group. The severity degree of coronary artery stenosiswas quantitively assessed according to coronary angiography by Gensini score. They were divided into four groups according to Gensini score: normal control group,Gensini score<30group,30-60group and≥60group. The serum levels of visfatin andMMP-9were measured by ELISA, hs-CRP was measured by immunoturbidimetry.Experimental data were processed by SPSS17.0statistical analysis software. A valueof p<0.05was considered statistically significant.Results:(1)The level of serum visfatin was significantly higher in patients with CHDthan in the control group [(10.77±2.63)μg/L vs (7.13±2.06)μg/L, P<0.05].(2)Visfatinwere significantly higher in patients with ACS than in both SAP and control group[(11.96±2.22)μg/L vs(8.61±1.83)μg/L, P<0.01;(11.96±2.22)μg/L vs (7.13±2.06)μg/L,P<0.01].(3) As the stenosis vessels and Gensini score increased, the visfatin levelsalso increased (P<0.05). The serum visfatin levels of single-, double-, multi-vesselgroup were9.30±2.19μg/L,10.81±2.12μg/L,12.80±2.20μg/L respectively. The serumvisfatin levels of Gensini score<30group,30-60group and≥60group were8.25±1.33μg/L,11.68±2.80μg/L,11.62±2.07μg/L respectively.(4) A positivecorrelation of visfatin levels analysed by linear regression with body massindex(BMI)(r=0.308, P<0.05), fasting blood glucose (FBG)(r=0.297, P<0.05),stenosis vessels (r=0.564, P<0.01), Gensini score (r=0.483, P<0.01) in CHD grouprespectively.(5) A significant positive correlation was found between visfatin andMMP-9, hs-CRP in patients with CHD(r=0.807, P<0.01; r=0.676, P<0.01). Thepositive correlation among serum visfatin, MMP-9and hs-CRP remained significantdespite correction for age, BMI, FBG and the number of coronary artery stenosis, etc.(partial r=0.364, P<0.01; r=0.528, P<0.01).(6) Logistic regression analysisdemonstrated that serum visfatin levels were associated with CHD(OR=6.915).Conclusions:(1)The level of serum visfatin was significantly increased in patientswith CHD, especially in ACS. Visfatin may be directly related to the initiation anddevelopment of coronary lesions.(2) Visfatin may be a new bond linking obesity,diabetes mellitus and CHD.(3) Visfatin should be regarded as an inflammatorymediator, play a role in plaque destabilization. The level of serum visfatin has thepredictive value in the occurrence of acute coronary events.(4) Serum visfatin levels are significantly associated with CHD, independent of well-known CHD risk factors.

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CLC: > Medicine, health > Internal Medicine > Heart, blood vessels ( circulatory ) disease > Heart disease > Coronary arteries ( atherosclerosis ),heart disease (CHD)
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