Objective: To investigate the relationship between serum specific serine protease inhibitor(Vaspin), adipose triglyceride lipase(ATGL) and risk factors and severity of coronary heart disease(CHD) in elderly patients. Methods: One hundred and twenty-four CHD patients(CHD group) and 80 healthy subjects(NC group) were selected. The clinical data of the two groups were collected. CHD-related hematological parameters were measured on the second day after admission. Coronary angiography was performed to assess the extent of coronary artery stenosis with Gensini score. Other indicators were recorded in the NC group except Gensini score and the results were then analyzed. Results: (1) The systolic blood pressure, diastolic blood pressure, body weight, BMI, smoking index, alcohol index, salt intake in CHD group were higher than those in NC group(P<0.05). (2) Vaspin, ATGL, INR, HDL-C of CHD group were lower than those of the NC group(P<0.05).The levels of FIB, TC, TG, LDL-C, Lp(a), blood glucose in CHD group were higher than those of NC group(P<0.05). No obvious coronary stenosis was found in NC group, and the improved Gensini score was 22.86±8.09 in CHD group. (3) Levels of Vaspin and ATGL were negatively correlated with systolic blood pressure, diastolic blood pressure, body weight, BMI, smoking index, drinking index and salt intake(P<0.05). (4) Vaspin and ATGL were negatively correlated with FIB, TC, TG, LDL-C, Lp(a), blood glucose, Gensini score(P<0.05),but positively correlated with INR and HDL-C(P<0.05). Conclusion: Vaspin and ATGL are closely related to the risk factors and the severity of coronary heart disease. Coronary heart disease risk factors may cause or aggravate the system disorder of body's sugar, lipid metabolism and coagulation, which may affect Vaspin and ATGL levels. Vaspin and ATGL may be a protective factor participating in the maintenance of metabolic balance.