载脂蛋白B基因多态性及血脂水平与慢性丙型肝炎的相关性  

Correlations of chronic hepatitis C virus infection with Xba I polymorphism of apolipoprotein B gene and serum lipid metabolism

作　　者：李雁[1] 刘正稳[1] 韩群英[1] 李晗[1] 

机构地区：[1]西安交通大学医学院第一附属医院传染科,陕西省西安市710061

出　　处：《世界华人消化杂志》2005年第23期2736-2741,共6页World Chinese Journal of Digestology

基　　金：国家自然科学基金资助项目;No 30170842~~

摘　　要：目的:探讨载脂蛋白B(Apo B)基因Xba Ⅰ位点多态性和血脂水平与慢性丙型肝炎之间的关系．方法:通过病例对照研究设计,采用聚合酶链式反应- 限制性片段长度多态性(PCR-RFLP)技术观察77例慢性丙型肝炎患者和62例健康对照者的Apo B基因Xba Ⅰ位点的多态性,采用全自动生化分析仪进行肝功、血脂水平的分析比较．结果:慢性丙型肝炎组和对照组Apo B基因Xba Ⅰ位点 X+X-,X-X-基因型构成不等,慢性丙型肝炎组X+等位基因频率低于对照组(0．071 vs 0．121,P=0．136),且病例组中肝硬化组X+等位基因频率低于慢性肝炎组,但未显示统计学的显著差异．病例组中不同病毒载量组间 Apo B基因Xba Ⅰ位点基因型分布存在显著差异,HCV RNA≥80 000 copies／L组X+等位基因频率低于HCV RNA<80 000 copies／L组(0．048 vs 0．179,P=0．035)．病例组中X+X-基因型的血清胆固醇(CHO)水平、低密度脂蛋白(LDL)水平及Apo B水平均高于X-X-组,而且 Apo B水平的差异具统计学显著性(P=0．019);血清高密度脂蛋白(HDL)水平低于X-X-组,但无统计学差异．慢性丙型肝炎患者血清Apo B水平和LDL水平与血清HCV RNA水平之间均呈直线负相关关系(分别为r= -0．538,P=0．005;r=-0．460,P=0．016),但与谷丙转氨酶(ALT)水平无相关性．结论:Apo B基因Xba Ⅰ位点的多态性与我国人群对 HCV的易感性没有直接联系,但与慢性丙型肝炎患者的病毒载量有关．X+等位基因频率可影响慢性丙型肝炎患者Apo B水平．慢性丙型肝炎患者血清LDL水平和 Apo B水平与血清HCV RNA水平显著相关．AIM： To investigate the Xba I locus polymorphisms of apolipoprotein B （Apo B） gene and their internal correlations with chronic hepatitis C virus infection and serum lipid metabolism. METHODS： Polymerase chain reaction-restriction fragment length polymorphism （PCR-RFLP） technique was used to analyze the genotype of the Apo B gene in 77 patients and 62 controls, according to the design of case control study. Meanwhile, the blood samples were analyzed for hepatic function and serum lipid by automatic biochemistry analyzer. RESULTS： The frequencies of X＋X- and X-X- of Xba I locus polymorphism were different between the patients and the controls and the frequency of X＋ allele in the patients was lower than that in the controls （0.071 vs 0.121, P = 0.136）, but no statistical significance was found. The frequency of X＋ allele in patients with HCV RNA≥80 000 copies/L was significantly lower than that with HCV RNA〈80 000 copies/L （0.048 vs 0.179, P = 0.035）. Furthermore, the levels of Apo B in the patients of X＋X- genotype were significantly higher than those in the patients of X-X- genotype （P = 0.019）. The serum levels of low density lipoprotein （LDL） and Apo B were negatively correlated with serum HCV RNA levels in patients with chronic hepatitis C （r = -0.460, P = 0.016; r = -0.538, P = 0.005, respectively）, and the correlation with serum alanine aminotransferase （ALT） levels was not found. CONCLUSION： The Xba I locus polymorphism of Apo B gene is not correlated with susceptibility of Chinese people to HCV, but it may affect the HCV viral load in patients with chronic hepatitis C. The variation of X＋ allele may affect serum Apo B levels in patients with chronic HCV infection. The serum levels of LDL and Apo B are closely correlated with serum HCV RNA levels in patients with chronic hepatitis C.

关 键 词：慢性丙型肝炎 载脂蛋白B基因 多态性 血脂 

分 类 号：R512.63[医药卫生—内科学] R541.4[医药卫生—临床医学]