载脂蛋白B编码基因突变与冠心病发病风险及传统危险因素交互作用  

Study on the interaction between apolipoprotein B gene mutation and coronary heart disease risk and traditional risk factors

作　　者：王艳[1] 袁艺[2] 淡雪川[1] WANG Yan;YUAN Yi;DAN Xuechuan(Department of Cardiology,The Second People's Hospital of Yibin,Yibin 644000,Sichuan,China;Department of Traditional Chinese Medicine,The Second People's Hospital of Yibin,Yibin 644000,Sichuan,China)

机构地区：[1]宜宾市第二人民医院心内科,四川宜宾644000 [2]宜宾市第二人民医院中医科,四川宜宾644000

出　　处：《西部医学》2020年第10期1542-1546,共5页Medical Journal of West China

摘　　要：目的探讨载脂蛋白B(APOB)编码基因突变与冠心病发病风险及传统危险因素的交互作用。方法回顾性选取我院2010年1月~2016年1月收治既往未接受降脂治疗冠心病患者和非冠心病患者各386例,均行APOB编码基因R532W位点突变检测,分析各基因型患者血脂水平,分析此位点突变与冠心病发病相关性,同时评估其与冠心病危险因素在疾病发生过程中交互作用。结果冠心病组患者高血压比例、糖尿病比例、吸烟比例、TC、LDL-C、Apo B及FBG水平均显著高于非冠心病组(P<0.05);同时冠心病组收缩压、舒张压、HDL-C、Apo AI及Apo AI/Apo B水平均显著低于非冠心病组(P<0.05);总纳入人群中AA型患者TC水平显著低于GA型(P<0.05);冠心病组AA型、GG型及GA型患者血脂指标水平比较差异无统计学意义(P>0.05);非冠心病组AA型患者TC水平显著低于GA型(P<0.05);非冠心病组和冠心病组患者POB编码基因R532W位点基因型分布频率比较差异有显著性(P<0.05);同时冠心病组最小等位基因A分布频率显著低于非冠心病组(P<0.05);显性遗传模型下,等位基因A携带者冠心病发病风险较未携带者降低29%(P<0.05);校正混杂因素后,等位基因A携带者冠心病发病风险较未携带者降低33%(P<0.05);隐性遗传模型和加性遗传模型下R532W位点突变与冠心病发病风险间无相关性(P>0.05);交互作用评价结果显示,APOB编码基因R532W位点突变和原发性高血压、吸烟史在冠心病发病过程中具有正相加交互效应(P<0.05),而与糖尿病具有负相加交互效应(P<0.05)。结论既往未接受降脂治疗人群APOB编码基因R532W位点突变与TC水平密切相关,并能够在一定程度上降低远期冠心病发生风险;同时此位点突变与高血压、吸烟间可形成正相加交互,而与糖尿病则存在负相加交互。Objective To investigate the interaction between apolipoprotein B gene mutation and attack risk of coronary heart disease and traditional risk factors.Methods Clinical data of 386 cases of coronary heart disease and 386 cases with non-coronary heart disease treated with no lipid-lowering therapy were chosen in the period from January 2010 to January 2016.R532 W mutation of ApoB coding gene was detected in all patients.The blood lipid level of different kinds of genotype was analyzed.The correlation between R532 W mutation and coronary heart disease were analyzed and the interaction between this mutation and risk factors of coronary heart disease were evaluated.Results The proportion of hypertension,diabetes,smoking,TC,LDL-C,apo B and FBG of CHD group were significantly higher than that of non-CHD group(P<0.05).The levels of SBP,DBP,HDL-C,Apo AI and Apo AI/Apo B of CHD group were significantly lower than that of non-CHD group(P<0.05).The TC levels of patients with AA type were significantly lower than that of GA type(P<0.05).There was no significant difference in serum lipid levels among CHD patients with AA type,GG type and GA type(P<0.05).The TC levels of non-CHD patients with AA type were significantly lower than that of GA type(P<0.05).There were significant differences in the genotype distribution of R532 W in POB coding gene between non CHD group and CHD group(P<0.05).The minimum allele A distribution frequency of CHD group were significantly lower than non-CHD group(P<0.05).In the dominant genetic model,the risk of coronary heart disease in allele A carriers were decreased for 29%lower than non carriers(P<0..05).After adjustment for confounding factors,the risk of coronary heart disease in allele A carriers were decreased for 33%lower than non carriers(P<0.05).There was no correlation between R532 W mutation and the risk of coronary heart disease in recessive genetic model and additive genetic model(P>0.05).The results of interaction evaluation showed that R532 W mutation in APOB coding gene and the history

关 键 词：载脂蛋白B 基因突变 冠心病 风险 危险因素 交互作用 

分 类 号：R541.4[医药卫生—心血管疾病]