脂蛋白(a)基因单核苷酸多态性变异与冠心病严重程度的关系  

Correlation between the variation of single-nucleotide polymorphism of lipoprotein(a)gene and the severity of coronary artery disease

作　　者：李志根 刘丰 陈竹君[2] 杨峻青[2] 罗德谋[2] 孙硕[2] 周颖玲[2] LI Zhi-gen;LIU Feng;CHEN Zhu-jun;YANG Jun-qin;LUO De-mou;SUN Shuo;ZHOU Ying-ling(Division of Cardiology,Department of Geriatrics,Guangzhou First People's Hospital,The Second Affiliated Hospital of South China University of Technology,Guangzhou 510180,China;Department of Cardiology,Guangdong Cardiovascular Institute,Guangdong Provincial People's Hospital,Guangdong Academy of Medical Sciences,Guangzhou 510080,China)

机构地区：[1]华南理工大学附属第二医院老年心内科,广州市第一人民医院,广州510180 [2]广东省心血管病研究所心内科,广东省人民医院(广东省医学科学院),广州510080

出　　处：《岭南心血管病杂志》2020年第3期282-286,320,共6页South China Journal of Cardiovascular Diseases

基　　金：广东省省级科技计划项目(项目编号:2011b061200030)。

摘　　要：目的探讨脂蛋白(lipoprotein,Lp)(a)基因单核苷酸多态性(single-nucleotide polymorphism,SNP)变异与冠状动脉(冠脉)粥样硬化性心脏病(冠心病)严重程度的相关性。方法入选2009年5月至2010年8月广东省人民医院冠脉造影证实的冠心病患者517例,采用TaqMan法对Lp(a)基因SNP rs6415084、rs3798220进行基因分型;采用Gensini评分计算患者的冠脉病变的严重程度。比较携带不同基因型患者的血脂浓度和Gensini评分。结果与Lp(a)正常组患者相比,Lp(a)升高组患者的rs6415084的变异单体频率(单体T)显著升高(15.4%vs.8.3%,P<0.001),但两组患者的rs3798220变异单体频率没有显著差异(P=0.174)。与含有rs6415084野生型基因(CC)的患者相比较,变异基因(CT/TT)患者的Lp(a)浓度明显升高[41.3(20.8~74.6)mg/dL vs.18.6(10.3~40.9)mg/dL,P<0.001],但两组患者的总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)和高密度脂蛋白胆固醇(HDL-C)浓度并没有明显差异(P均>0.05);然而,rs3798220的两个基因型分组之间的Lp(a)和其他血脂成份浓度均没有显著差异(P均>0.05)。与携带rs6415084野生型基因的患者相比较,携带rs6415084变异基因患者的冠脉Gensini评分显著升高(46.0±16.5 vs.42.2±15.6,P=0.025);然而,rs3798220的两个基因型患者的冠脉的Gensini评分没有显著差异(P=0.384)。结论rs6415084变异与冠心病患者的Lp(a)浓度相关,并且rs6415084变异可能与冠心病患者的冠脉严重程度相关。Objectives To investigate the correlation between the variation of single-nucleotide polymorphism(SNP)of lipoprotein(a)[Lp(a)]gene and the severity of coronary artery disease(CAD).Methods Totally 517 patients with CAD confirmed by coronary angiography from May 2009 to August 2010 in Guangdong Provincial People's Hospital were recruited.The genotypes of Lp(a)gene SNP rs6415084 and rs3798220 were genotyped by TaqMan method,and the severity of CAD was calculated by Gensini score.The serum concentration of lipid and Gensini scores of patients with different genotype were compared.Results Compared with normal Lp(a)group,the frequency of rs6415084 variant monomer(T)in elevated Lp(a)group was significantly higher(15.4%vs.8.3%,P<0.001).However,there was no significant difference in rs3798220 variant monomer frequency between the two groups(P=0.174).Compared with patients with wild type gene rs6415084(CC),the concentration of Lp(a)in patients with variant gene(CT/TT)was significantly higher[41.3(20.8-74.6)mg/dL vs.18.6(10.3~40.9)mg/dL,P<0.001],but there was no significant difference in concentration of total cholesterol(TC),triglyceride(TG),low-density lipoprotein(LDL-C)and highdensity lipoprotein(HDL-C)between the two groups(P>0.05);however,the concentration of Lp(a)and other lipid components between the two genotypes of rs3798220 were not significantly different.Compared with the patients with wild type genes,the Gensini scores of the patients with variant genes of rs6415084 were significantly higher(46.0±16.5 vs.42.2±15.6,P=0.025);however,there was no significant difference in the Gensini score between the two genotypes of rs3798220(P=0.384).Conclusions Only rs6415084 variant is associated with concentration of Lp(a)in patients with CAD.The variant rs6415084 may be related to the severity of coronary artery in patients with CAD.

关 键 词：冠状动脉疾病 脂蛋白(a) 基因变异 冠状动脉病变严重程度 

分 类 号：R541.4[医药卫生—心血管疾病]