ApoE基因多态性与血清脂质水平及冠状动脉狭窄严重程度的相关性研究  

Correlation among ApoE gene polymorphism and serum lipid level as well as coronary artery stenosis

作　　者：刘虹宏 张冬花[1] 程宇彤[1] 王苏[1] 张京梅[1] 李志忠[1] 林运[1] LIU Honghong;ZHANG Donghua;CHENG Yutong;WANG Su;ZHANG Jingmei;LI Zhizhong;LIN Yun(Department of Cardiology,Beijing Anzhen Hospital,Capital Medical University,Beijing,100029,China)

机构地区：[1]首都医科大学附属北京安贞医院心内科,北京100029

出　　处：《临床心血管病杂志》2021年第5期478-484,共7页Journal of Clinical Cardiology

摘　　要：目的:研究ApoE基因多态性与血清脂质水平及冠状动脉(冠脉)狭窄严重程度的相关性。方法:纳入2017年8月—2017年12月在北京安贞医院初次行冠脉造影的患者561例。采集研究对象性别、年龄、身高、体重、是否有高血压病史、是否有糖尿病病史等危险因素信息,完善空腹血生化的检查,包括总胆固醇(TC)、甘油三酯(TG)、HDL、LDL、C反应蛋白(CRP)、同型半胱胺酸(HCY)等指标水平。同时采集研究对象外周血样本以提取基因组DNA,使用ApoE基因检测试剂盒检测研究对象的ApoE基因分型。结果:研究对象有349例(62.21%)诊断为冠心病,其中中度狭窄的有61例(10.87%),重度狭窄的有288例(51.34%)。从基因分型的分布看,Apo E2/E2、Apo E2/E3、Apo E3/E3、Apo E3/E4、Apo E2/E4、Apo E4/E46种基因型研究对象占比分别为0.53%、10.16%、72.73%、14.62%、1.43%、0.53%。ApoE不同基因分型在性别、糖尿病史、高血压病史、是否为冠心病等影响因素中分布差异无统计学意义(P>0.05)。而不同的基因分型其冠脉的狭窄程度具有显著差异(P=0.03)。ApoE不同等位基因及蛋白亚型与血清脂质水平、BMI、CRP、HCY间差异均无统计学意义(P>0.05),但不同基因分型其脂质水平具有明显的相关性。在危险因素的Logistic回归分析中,男性和患有糖尿病是冠心病患病的危险因素,男性是冠脉狭窄程度的危险因素,而突变型的ApoE蛋白亚型其冠心病患者重度狭窄的概率为野生型ApoE蛋白亚型的1.38倍,尽管差异无明显意义。结论:ApoE基因多态性是冠脉狭窄程度的影响因素,性别是冠心病患病及冠脉狭窄程度的危险因素,糖尿病是冠心病患病的危险因素。尽管ApoE基因多态性与血脂水平、CRP、HCY水平间的差异无统计学意义,但不同ApoE基因其脂质水平、CRP、HCY呈一定变化趋势。Objective:To study the correlation between ApoE gene polymorphism and serum lipid level and coronary artery stenosis severity.Methods:We concluded our study based on 561 patients underwent coronary angiography in Beijing Anzhen Hospital from August 2017 to December 2017.Within our study,a collection of gender,age,height,weight,history of hypertension has been made which were the risk factors of Cardiovascular risk factors.At the same time,total cholesterol(TC),triglyceride(TG),HDL,LDL and C-Reactive Protein(CRP),Homocysteine(HCY)concentration level have been measured.Meanwhile we extracted DNA,and were to conduct a genotyping on ApoE of all 561 patients with the use of ApoE gene detection kit.Results:Among all 561 patients,349(62.21%)were diagnosed with coronary heart disease,among which 61(10.87%)had moderate stenosis and 288(51.34%)had severe stenosis.According to the genotyping distribution,the study subjects of Apo E2/E2,Apo E2/E3,Apo E3/E3,Apo E3/E4,Apo E2/E4,and Apo E4/E46 genotypes accounted for 0.53%,10.16%,72.73%,14.62%,1.43%,and 0.53%,respectively.There were no statistically significant differences in the distribution of ApoE genotypes among sex,history of diabetes,history of hypertension,coronary heart disease and other influencing factors(P>0.05).The degree of coronary artery stenosis was significantly different among different genotypes(P=0.03).There were no statistically significant differences between different ApoE alleles and protein isoforms and serum lipid level,BMI,CRP and HCY(P>0.05),but lipid level of different genotypes showed significant differences.In the multivariate Logistic regression analysis of risk factors,gender(male)and diabetes were risk factors for coronary heart disease,and gender of male was more likely to have more severe degree of stenosis than that of female.The probability of ApoE protein subtype mutation was 1.38 times higher than that of wild ApoE protein subtype for severe coronary heart disease stenosis,although there was no significant difference.Conclusion:ApoE gene

关 键 词：APOE基因多态性 血清脂质水平 冠脉狭窄 危险因素 

分 类 号：R543[医药卫生—心血管疾病]