上海某社区老年男性高血压病病人ApoE基因型与中医证型及血脂的相关性分析  

The Correlation between ApoE Genotype and Traditional Chinese Medicine Syndrome and Blood Lipid in Elderly Male Hypertensive Patients in Shanghai Community

作　　者：居励之 林赟霄 吴琼 曹敏[1] 彭珑萍 董艺丹 张成辉 施锦绣 王佑华[1] JU Lizhi;LIN Yunxiao;WU Qiong;CAO Min;PENG Longping;DONG Yidan;ZHANG Chenghui;SHI Jinxiu;WANG Youhua(Longhua Hospital Shanghai University of Traditional Chinese Medicine,Shanghai 200032,China;Shanghai Xuhui District Tianping Street Community Health Service Center,Shanghai 200031,China)

机构地区：[1]上海中医药大学附属龙华医院,上海200032 [2]上海市徐汇区天平街道社区卫生服务中心,上海200031 [3]诸暨市人民医院 [4]上海人类基因组研究中心

出　　处：《中西医结合心脑血管病杂志》2020年第23期3998-4002,共5页Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease

基　　金：国家中医药管理局国家中医临床基地业务建设专项(No.JDZX2012114);上海市徐汇区医学科研项目(No.SHXH201832)。

摘　　要：目的分析载脂蛋白E(apolipoprotein E,ApoE)基因型与老年男性高血压病病人中医证型及血脂的相关性,探索高血压病病人中医证型与血脂表型的遗传基础,为临床辨治高血压病提供新的思路。方法收集上海某社区体检老年男性高血压病病人284例,应用二代测序技术检测ApoE基因突变,分析老年男性高血压病病人的ApoE基因型与中医证型及血脂之间的相关性。结果4种中医证型病人年龄、吸烟、体质指数(BMI)、血脂比较差异无统计学意义(P>0.05);ApoE基因测序共检测出22个突变位点,均符合Hardy-Weinberg平衡(P>0.05)。其中rs769449、rs429358、rs7412突变率分别为13.38%、14.79%、13.03%。rs769449、rs429358、rs7412基因型在4种中医证型间的分布比较差异无统计学意义(P>0.05)。在肝火亢盛证中,rs7412 CC型、CT+TT型在三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)比较差异有统计学意义(P<0.05),在阴虚阳亢证中,rs769449 GG型、CA+AA型基因型在TC、LDL-C和HDL-C水平比较差异具有统计学意义(P<0.05);rs429358 TT型、TC+CC型在HDL-C比较差异具有统计学意义(P<0.05)。在痰瘀互结证中,rs429358 TT型、TC+CC型基因型在TC、LDL-C的水平比较差异有统计学意义(P<0.05)。结论老年男性高血压病病人中,rs7412 CC型是肝火亢盛证血脂异常的保护因素,rs769449 GG型是阴虚阳亢证血脂异常的保护因素,rs429358 TT型是阴虚阳亢证及痰瘀互结证血脂异常的危险因素。Objective To analyze the correlation between apolipoprotein E(ApoE)genotype and traditional Chinese medicine(TCM)syndrome and blood lipid in elderly male hypertensive patients in Shanghai community,exploring the genetic basis of TCM syndromes and lipid phenotypes in hypertensive patients and providing a new way for clinical differentiation and treatment of hypertension.Methods Two hundred and eighty-four elderly hypertensive patients were collected.ApoE gene mutation was examined by second-generation sequencing.The correlation between ApoE genotype,TCM syndromes and blood lipid in elderly male hypertensive patients was analyzed.Results There was no significant difference in age,smoking history,body mass index(BMI)and blood lipid between TCM syndromes(P>0.05).A total of 22 mutation sites were detected by ApoE gene sequencing,which were in accordance with Hardy-Weinberg equilibrium(P>0.05).The mutation rates of rs769449,rs429358 and rs7412 were 13.38%,14.79%and 13.03%.There was no significant difference in the distribution of rs769449,rs429358 and rs7412 genotypes among the four TCM syndromes(P>0.05).In the hyperactivity of liver-fire syndrome,the difference of rs7412 CC and CT+TT in triglyceride(TG),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C)was significant(P<0.05).In Yin deficiency and Yang hyperactivity Syndrome,the difference of rs769449 genotype in TC,LDL-C and HDL-C were statistical significance(P<0.05).The difference of rs429358 TT and TC+CC in HDL-C was statistically significant(P<0.05).In the syndrome of phlegm and blood stasis,the difference of rs429358 genotype in TC and LDL-C was significant(P<0.05).Conclusion rs7412 CC type in elderly male hypertensive patients was a protective factor for dyslipidemia in the hyperactivity of liver-fire syndrome,rs769449 GG type was the protective factor of dyslipidemia in Yin deficiency and Yang hyperactivity syndrome,and rs429358 TT type was a risk factor of dyslipidemia in Yin deficiency and Yang hyperactivity syndrome and p

关 键 词：高血压 中医证型 APOE基因型 血脂 上海 老年男性 

分 类 号：R544.1[医药卫生—心血管疾病] R255.3[医药卫生—内科学]