影响安庆农村地区H型高血压发生的遗传和环境因素  

Genetic and environmental factors for H-type hypertension in Anqing rural community

作　　者：宗永华[1] 徐希平[2] 霍勇[3] 蒋善群[2] 王旭[2] 肖凡凯[4] 赵洛沙[1] 

机构地区：[1]郑州大学第一附属医院心血管内科,河南450003 [2]安徽医科大学生物医学研究所 [3]北京大学第一医院心血管科 [4]天津医科大学08级临床医学系

出　　处：《中华高血压杂志》2011年第5期445-449,共5页Chinese Journal of Hypertension

摘　　要：目的探索影响安庆农村地区H型高血压发病风险的危险因素。方法 2007-07-2008-10在安徽省安庆市白湖镇、汤沟镇及偶山镇筛选首诊高血压患者,采用PCR-RLFP法对高血压人群测定N5,10亚甲基四氢叶酸还原酶(MTHFR)C677T基因型,再按照CC、CT和TT基因型1∶1∶1配对入选初诊高血压患者241例,应用高效液相色谱荧光检测法检测空腹血浆同型半胱氨酸(Hcy)水平,检测血脂,同时测量患者血压、身高、体质量,问卷了解年龄、饮酒史、吸烟史。结果安徽省安庆地区高血压人群Hcy水平男性高于女性[(12·8±7·2)比(9·7±4·7)μmol/L],差异有统计学意义(P<0·01);MTHFRC677T基因中TT基因型人群Hcy水平高于CC/CT基因型(P<0·01)。高血压人群中H型高血压比例44·4%,男性高于女性(60·3%比29·6%,P<0·05),其中男性TT基因型的比例高达80·6%;H型高血压在TT基因型中的比例高于CC/CT基因型(P<0·01)。相关变量与Hcy水平的多元线性回归分析中,未发现年龄、饮酒、吸烟、体质量指数、血压与Hcy水平相关(P>0·05);多元logistic回归模型也未发现年龄、饮酒、吸烟、体质量指数和血压与H型高血压发生风险有关(P>0·05)。结论安庆农村地区人群中MTHFRC677T基因突变可能是H型高血压发病的重要遗传因素且存在性别差异,年龄、吸烟、饮酒、体质量指数和血压可能不是H型高血压的危险因素。Objective To explore related risk factors for H-type hypertension in rural areas of Anqing, Anhui. Methods From July 2007 to October 2008, Hypertensive patients from Baihu, Tanggou and Oushan regions of Anqing, Anhui, were screened with polymerase chain reaction-restriction fragment length polymorphism （PCR-RFLP） to detect the C677T polymorphism of N5,10 methylenetetrahydrofolate reductase （MTHFR） gene. Two hundred and forty one patients with hypertension were enrolled in our study and assigned to each MTHFR genotype（CC, CT, TT）. Meanwhile, fasting plasma Hcy level was measured with HPLC, blood pressure and body mass index （BMI） were acquired from all the patients. A questionnaire was used to collect the lifestyle informations of cigarette and/or alcohol consumption status. Results The average level of fasting plasma Hcy was significantly higher in male than female [（12.8±7.2） vs （9.7±4.7） μmol/L, P0.01]; Patients with TT genotype had a significantly higher level of Hcy than those with CC or CT genotypes（P0.01）. The proportion of H-type hypertension in all the hypertension cases was up to 44.4%. H-type hypertension was much more common in male patients, which was 60.3% compared to 29.6% in female. The risk of H-type hypertension in TT genotype was pronouncedly higher than in CT and CC genotypes（OR, 3.2, 95% CI 1.7-5.8, P0.01）. Multiple linear/logistic regression analysis with adjustment by multivariate didn＇t identify marked relevance of Hcy level or H-type hypertension risk with other environmental variables including age, alcohol drinking, cigarette smoking, BMI, and baseline diastolic blood pressure（DBP） and systolic blood pressure（SBP）. Conclusion Our present study suggested that the MTHFR C677T genetic variant with gender may be associated with a high risk of H-type hypertension, but not for drinking, smoking, age, BMI and blood pressure, in rural community of Anqing, China.

关 键 词：H型高血压 基因多态性 环境因素 性别 

分 类 号：R544.1[医药卫生—心血管疾病]