脂蛋白(a)基因单核苷酸多态性与钙化性主动脉瓣疾病及冠心病的关系  

Correlations of lipoprotein(a)gene polymorphisms with calcific aortic valve disease and coronary heart disease

作　　者：董红志 丛洪良[2] 王菁[3] 姜亦瑶[4,5] 刘超 张迎怡[2] 朱延波[7] 王庆彤[8] Dong Hongzhi;Cong Hongliang;Wang Jing;Jiang Yiyao;Liu Chao;Zhang Yingyi;Zhu Yanbo;Wang Qingtong(Graduate School,Tianjin Medical University 300070,China;Department of Cardiology,Tianjin Chest Hospital,Tianjin 300051,China;Department of Pathology,Tianjin Chest Hospital,Tianjin 300051,China;Department of Cardiovascular Surgery,the First Affiliated Hospital of Bengbu Medical College,Bengbu 233004,China;Department of Cardiovascular Surgery,the First Central Hospital Affiliated to Nankai University,Tianjin 300192,China;Institution of Cardiovascular Disease,Tianjin Chest Hospital,Tianjin 300051,China;Department of Ultrasonography,Tianjin Chest Hospital,Tianjin 300051,China;Department of Clinical Laboratory,Tianjin Chest Hospital,Tianjin 300051,China)

机构地区：[1]天津医科大学研究生院,300070 [2]天津市胸科医院心内科,300051 [3]天津市胸科医院病理科,300051 [4]蚌埠医学院第一附属医院心脏大血管外科,安徽省蚌埠市233004 [5]南开大学附属第一中心医院心血管外科,天津300192 [6]天津市胸科医院心血管病研究所,300051 [7]天津市胸科医院超声科,300051 [8]天津市胸科医院检验科,300051

出　　处：《中华解剖与临床杂志》2020年第3期265-271,共7页Chinese Journal of Anatomy and Clinics

基　　金：国家自然科学基金(81800214);安徽省自然科学基金(1808085QH236);天津市科委慢性疾病防治科技重大专项(16ZXMJSY00140)。

摘　　要：目的探讨脂蛋白(a)[Lp(a)]基因单核苷酸多态性(SNP)与钙化性主动脉瓣膜疾病(CAVD)、冠心病(CHD)的相关性。方法前瞻性研究。纳入2018年1—12月天津市胸科医院心内科CAVD或CHD住院患者248例,根据心脏超声多普勒、冠状动脉造影或冠状动脉CT检查结果分为两组:CAVD组101例、CHD组147例;同时选取2018年3—12月天津市胸科医院体检中心排除CAVD或CHD的171位健康体检者为对照组。检测各组Lp(a)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)、载脂蛋白A(ApoA)、载脂蛋白B(ApoB)等生化指标,采用SNaPshot SNP分型技术对Lp(a)基因rs7770628、rs6415084、rs10455872三个位点进行基因分型;采用二元logistic回归分析不同基因型及Lp(a)水平对钙化性主动脉瓣疾病及冠心病发病的影响,采用线性回归分析不同基因型及ApoB水平对Lp(a)水平的影响。结果三组间比较,患者BMI和饮酒史差异均无统计学意义(P值均>0.05),性别、年龄、吸烟史、糖尿病史、高血压病史差异均有统计学意义(P值均<0.05)。Lp(a)检测值在对照组、CAVD组、CHD组分别为23.6(9.4,48.6)、37.2(16.5,79.6)、46.7(21.5,104.6)nmol/L,三组间比较差异有统计学意义(H=13.337,P<0.01);LDL值各组分别为(2.74±0.80)、(3.07±0.81)、(3.14±1.18)mmol/L,三组间差异有统计学意义(F=3.662,P<0.05);HDL值各组分别为(1.24±0.93)、(1.18±0.30)、(1.09±0.33)mmol/L,三组间比较差异有统计学意义(F=4.281,P<0.05);ApoA值各组分别为(1.42±0.25)、(1.30±0.26)、(1.26±0.26)g/L,三组间比较差异有统计学意义(F=7.339,P<0.01);ApoB检测值各组分别为0.97(0.82,1.10)、1.04(0.87,1.26)、1.12(0.88,1.31)g/L,三组间比较差异有统计学意义(H=3.948,P<0.05)。Lp(a)基因rs7770628位点对照组、CAVD组、CHD组TT基因型分别为130(76.0%)、75(74.3%)、103(70.1%),CT基因型分别为36(21.1%)、23(22.8%)、40(27.2%),CC基因型分别为5(2.9%)、3(2.9%)、4(2.7%),三组间比较差异无统计学意义(F=1.718,P>0.05);LpObjective To investigate the relationships of lipoprotein(a)[Lp(a)]gene polymorphism with calcified aortic valve disease(CAVD)and coronary heart disease(CHD).Methods Prospective study.A total of 248 patients with CHD or CAVD diagnosed in the Department of Cardiology of Tianjin Chest Hospital from January to December 2018 were divided into two groups,namely,the CAVD group(101 cases)and the CHD group(147 cases),in accordance with the results of color Doppler echocardiography,coronary angiography,and computed tomography angiography.The control group,which was composed of 171 cases who neither had CHD nor CAVD,was selected from the physical examination center from March to December 2018.Biomarkers,including Lp(a),low-density lipoprotein(LDL),high-density lipoprotein(HDL),apolipoprotein A(ApoA),and apolipoprotein B(ApoB)were tested.The SNaPshot single nucleotide polymorphism method was used to detect Lp(a)gene loci rs10455872,rs6415084,and rs7770628.Binary logistic regression was performed to analyze the effects of different genotypes and Lp(a)levels on CAVD or CHD,and linear regression was conducted to analyze the effects of different genotypes and ApoB levels on Lp(a)levels.Results There were no statistically significant differences in BMI and drinking history among the three groups(all P values>0.05),and there were statistically significant differences in gender,age,smoking history,history of diabetes and hypertension(all P values<0.05).The Lp(a)quartile values of the control,CAVD,and CHD groups were 23.6(9.4,48.6),37.2(16.5,79.6),and 46.7(21.5,104.6)nmol/L,respectively,and exhibited a statistically significant difference(H=13.337,P<0.01).The LDL values of the control,CAVD,and CHD groups were(2.74±0.80),(3.07±0.81),and(3.14±1.18)mmol/L,respectively,and demonstrated a statistically significant difference(F=3.662,P<0.05).The HDL values of the control,CAVD,and CHD groups were(1.24±0.93),(1.18±0.30),and(1.09±0.33)mmol/L,respectively,and presented a statistically significant difference(F=4.281,P<0.05).The ApoA val

关 键 词：冠心病 脂蛋白(a) 脂蛋白(a)基因 单核苷酸基因多态性 钙化性主动脉瓣疾病 

分 类 号：R542.52[医药卫生—心血管疾病] R541.4[医药卫生—内科学]