职业紧张和β_2-AR基因多态性与高血压关系的病例对照研究  

Case Control Study of the Effect of Occupational Stress and Gene Polymorphisms of β_2-AR on Hypertension

作　　者：余善法[1] 周文慧[1] 谷桂珍[1] 邱英[1] 吴艳延[1] 王生[2] 

机构地区：[1]河南省职业病防治研究所,河南郑州450052 [2]北京大学公共卫生学院,北京100191

出　　处：《工业卫生与职业病》2010年第2期93-98,共6页Industrial Health and Occupational Diseases

基　　金：河南省医学科技创新人才工程计划项目(2001-23;2004-62)

摘　　要：目的探讨职业紧张和β2-AR基因多态性对高血压的影响。方法采用整群抽样的方法,对热电厂工龄〉2 a的498名在职工人进行调查,调查内容包括职业紧张因素、个性特征、缓解因素、职业紧张反应及高血压的其他常见危险因素,使用付出？回报失衡（ERI）模式、工作内容问卷和职业紧张测量工具等问卷进行职业紧张测评,常规方法测定血清甘油三酯、总胆固醇及空腹血糖水平。从上述调查对象中选择58例确诊为高血压的男性患者和58例性别、年龄、工龄和工种等与之相匹配的正常对照者,采用PCR-RFLP方法对外周血标本进行β2AR-16（Arg→Gly）和β2AR-27（Gln→Glu）多态性检测。应用SPSS 13.0软件进行条件Logistic回归分析。结果ERI值高者高血压患病的危险是比值低者的4.2-5.0倍。携带Arg/Gly个体的高血压患病危险是携带Arg/Arg个体的3.21倍,携带Gln/Glu个体的高血压患病危险是携带Gln/Gln个体的8.0倍;携带Gln27等位基因的个体,高血压发生率更低。ERI和β2AR-16（Arg→Gly）多态性的交互作用对高血压的发生存在影响（OR=2.6）。ERI和β2AR-27（Gln→Glu）多态性的交互作用对高血压的发生存在影响（OR=2.3）;ERI和Gly16等位基因以及ERI和Gln27等位基因对高血压的发生存在交互作用（OR分别为6.2和1.6）;未发现工作紧张模式有关因素和β2-AR基因多态性对高血压的发生存在独立和交互作用。结论职业紧张和β2AR-16多态性及ERI和β2AR-27多态性的交互作用对高血压的发生存在影响。Objective To explore the effect of occupational stress and gene polymorphisms of β2-AR on hypertension.Methods498 workers from a thermal power plant in Henan province in China,whose accumulative length of service was more than two years were investigated with questionnaire by the method of cluster sampling.The occupational stressors,personalities,buffering factors and occupational strain were measured by using the Job Demand-control Model,the Effort-reward Imbalance Model questionnaires and Occupational Stress Measurement Scale.Some main risk factors for the development of hypertension were investigated,such as heredity,body mass index,high salt diet,alcohol use and lack of physical activity.At the same time,the level of TG,CHO and FPG were detected by the common biochemistry methods.β2-AR genotypes and alleles frequencies at amino acid position 16（β2AR-16：Arg→Gly）and at position 27（β2AR-27：Gln→Glu） of the 116 samples from field epidemiologic survey were detected by PCR-RFLP technology,including 58 males with hypertension and 58 healthy people matched in gender,age,and length of service.The direct and interaction effects of individual demographic variables,occupational stressors,personalities,buffering factors,affection and β2-AR genotypes or alleles on prevalence of hypertension were analyzed by using conditional logistic regression in 1∶1 matched-pairing case-control design.All significant statements were two-tailed.An alpha of 5% was used for all statistical analyses.All analyses were conducted using SPSS 13.0.Results（1）The workers with higher ERI were more likely to suffer hypertension than whom with lower ERI（OR=4.2~5.0）.（2）The results of Cox-regression analyses showed that the risk of hypertension for Arg/Gly carriers was 3.21 times as high as that for Arg/Arg carriers.The same pattern of results,but with stronger effects,was found with regard to ERI（OR=4.2）.Arg/Gly and Gly/Gly genotypes were associated with hypertension,it was found that the interaction effect of Gly1

关 键 词：职业紧张 β2-AR基因多态性 高血压 病例对照研究 

分 类 号：R135[医药卫生—劳动卫生] R395.6[医药卫生—公共卫生与预防医学]