高血压患者亚甲基四氢叶酸还原酶基因C677T多态性与血脂异常的相关性  

Correlation between methylenetetrahydrofolate reductase gene C677T polymorphism and blood lipid abnormality among hypertensives

作　　者：范贵娟 徐瑞[2] 张琪[1,2] 贠琳[2] 曹艳丽[1,2] 张春梅[1,2] FAN Gui-Juan XU Rui ZHANG Qi YUN Lin CAO Yan-Li ZHANG Chun-Mei(Shandong University of Traditional Chinese Medicine Department of Cardiology, Qianfoshan Hospital Affiliated to Shandong University, Jinan, Shandong 250014, China)

机构地区：[1]山东中医药大学 [2]山东大学附属千佛山医院心内二科,山东省济南市250014

出　　处：《中国动脉硬化杂志》2017年第2期153-158,共6页Chinese Journal of Arteriosclerosis

基　　金：山东省科技发展计划项目(2014GSF118055);山东省医药卫生科技发展计划项目(2013WS0130)

摘　　要：目的探讨血浆同型半胱氨酸(Hcy)及其代谢关键酶亚甲基四氢叶酸还原酶(MTHFR)C677T基因多态性与中国汉族人群原发性高血压患者血脂异常的关系。方法选取原发性高血压患者312例,女性134例,男性178例,平均年龄58.25岁,收集患者基本资料,检测血浆Hcy、血脂、空腹血糖(FBG)、尿酸(UA)等临床生物化学指标。应用Taqman探针技术检测患者MTHFR C677T基因分型。根据2007年中国成人血脂异常防治指南,将入选的312例原发性高血压患者分为血脂异常组194例和血脂正常组118例,同时将血脂异常组分为4个亚组:高胆固醇血症组54例,高甘油三酯血症组53例,混合型高脂血症组59例,低高密度脂蛋白血症组22例,并进行亚组分析。结果血脂异常组体质指数(BMI)、FBG、UA高于血脂正常组(P<0.01)。血脂异常组MTHFR C677T的CC、CT、TT三种基因型频率和C、T两种等位基因频率与血脂正常组比较差异无统计学意义(P>0.05),血脂异常各亚组之间的基因型频率、等位基因频率差异无统计学意义,与血脂正常组之间差异亦无统计学意义。MTHFR C677T不同基因型间四项血脂水平均无统计学差异,但TT基因型者Hcy水平高于CT、CC基因型者(P<0.05),而CT基因型者Hcy水平与CC基因型者比较差异无统计学意义(P>0.05)。高密度脂蛋白胆固醇(HDLC)水平与Hcy水平呈负相关(r=-0.116,P<0.05),但是在校正了年龄、BMI、UA、FBG后此相关性消失;总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDLC)水平与Hcy水平无相关性(P>0.05)。Logistic回归分析显示,在校正了BMI、FBG、UA后基因型与血脂异常无相关性(P>0.05)。结论在原发性高血压患者中MTHFR C677T基因多态性与血脂异常无关联,而与Hcy呈显著相关。血脂异常与FBG、UA、BMI有关,而与Hcy无关,但HDLC与血浆Hcy水平呈负相关。Aim To investigate the association between plasma homocysteine （Hcy） and the C677T gene polymorphism of its key metabolic enzyme, methylenetetrahydrofolate reductase （MTHFR）, and blood lipid abnormality among hypertensives of Chinese Han population. Methods A total of 312 adult essential hypertensive patients were selected as the study subjects. The average age of the selected patients was 58.25 years old, 178 cases were male, 134 cases were female. The personal information was collected, clinical biochemical indicators were tested, including plasma Hcy, serum lipid, fasting blood glucose （FBG）, uric acid （UA） and so on. The C677T gene polymorphism of MTHFR was tested. According to guidelines for prevention and treatment of serum lipid in Chinese adults published in 2007, 194 cases were elected out as essential hypertension with blood lipid abnormality group and 118 cases as blood lipid normality group, and the blood lipid abnormality group was divided into 4 subgroups ： 54 cases of hypercholesterolemia group, 53 cases of hypertriglyceridemia group, 59 cases of mixed hyperlipidemia, and 22 cases of hypo high density lipoprotein cholesterolemia group, and subgroup analysis was performed. Results The body mass index （BMI） , FBG, and UA of the blood lipid abnormality group were higher than those in the the blood lipid normality group （P〈0.01）. There was no significant difference in the MTHFR C677T genotype frequency and allele frequency between blood lipid abnormality group and bh）od lipid normality group. Subgroup analysis showed that there was no significant difference in the MTHFR C677T genotype frequency and allele frequency among different subgroups, and also no significant difference between subgroups and blood lipid normality group. The level of different blood lipid was not significant among genotypes. The level of lfcy in TT genotype was higher than that in CT and CC genotype （P〈0.05）, the level of Hcy was not significant between CT and CC genotype （ P〉0.05 ）. Plasm

关 键 词：亚甲基四氢叶酸还原酶 基因多态性 血脂异常 同型半胱氨酸 

分 类 号：R5[医药卫生—内科学]