ApoA1/2基因多态性与HDL-C水平在老年冠心病心血管死亡与全因死亡中的交互作用研究  

Interaction between ApoA1/2 gene polymorphism and HDL-C in cardiovascular death and all-cause death in elderly patients with coronary heart disease

作　　者：李少君 李静 于佳新[2] 张沛[2] LI Shaojun;LI Jing;YU Jiaxin;ZHANG Pei(Department of Clinical Laboratory,Tangshan Hospital of Traditional Chinese Medicine,Tangshan,Hebei 063000,China;Department of Cardiology,Tangshan Workers Hospital,Tangshan,Hebei 063000,China)

机构地区：[1]河北省唐山市中医医院检验科,河北唐山063000 [2]河北省唐山市工人医院心内科,河北唐山063000

出　　处：《国际检验医学杂志》2022年第20期2510-2515,共6页International Journal of Laboratory Medicine

基　　金：河北省医学科学研究课题计划(20210519)。

摘　　要：目的探讨载脂蛋白(Apo)A1/2基因多态性与高密度脂蛋白胆固醇(HDL-C)水平在老年冠心病心血管死亡与全因死亡中的交互作用。方法选取2015年1月至2016年1月唐山市中医医院收治的385例老年冠心病患者作为研究对象,根据5年预后情况(失访36例)分为死亡组(61例)和存活组(288例),比较两组患者一般资料、ApoA1/2基因多态性、HDL-C水平,采用比值比(OR)和95%置信区间(CI)评估基因突变对心血管死亡与全因死亡的相对危险度,并采用多因素Logistic回归分析ApoA1/2基因多态性与HDL-C水平在心血管死亡与全因死亡中的交互作用,使用交互作用系数(γ)分析ApoA1/2基因多态性与HDL-C水平对心血管死亡与全因死亡是否存在交互作用及其作用类型。结果两组患者ApoA1-75G/A基因型与等位基因分布比较,差异均有统计学意义(P<0.05);死亡组患者HDL-C水平低于存活组,差异有统计学意义(P<0.05);ApoA1-75G/A基因型AA患者HDL-C水平高于基因型GA患者和基因型GG患者,两两比较差异均有统计学意义(P<0.05);ApoA1-75G/A基因型GA、AA及HDL-C均为心血管死亡与全因死亡的影响因素(P<0.05);单独HDL-C水平降低所致的OR为5.691,单独ApoA1-75G/A基因突变所致的OR为0.400,二者同时存在时,交互作用的OR为5.333,且γ为0.931,ApoA1-75G/A基因型GA、AA与HDL-C水平降低在心血管死亡与全因死亡中呈负向交互作用,同时ApoA1-75G/A基因突变与HDL-C水平降低的交互作用符合超相乘模型。结论ApoA1/2基因多态性、HDL-C水平均与老年冠心病心血管死亡与全因死亡有关,且ApoA1-75G/A基因突变可减低因HDL-C水平降低对心血管死亡与全因死亡的影响效应,呈现出预后保护作用。Objective To investigate the interaction between apolipoprotein(Apo)A1/2 gene polymorphism and high-density lipoprotein cholesterol(HDL-C)level in cardiovascular death and all-cause death in elderly patients with coronary heart disease.Methods A total of 385 elderly patients with coronary heart disease admitted to Tangshan Hospital of traditional Chinese Medicine from January 2015 to January 2016 were selected as research objects,and were divided into death group(61 cases)and survival group(288 cases)according to the 5-year prognosis(36 cases missed).The general data,ApoA1/2 gene polymorphism,HDL-C level were compared in the two groups,and odds ratio(OR)and 95%confidence interval(CI)were used to assess the relative risk of genetic mutations to cardiovascular death and all-cause death.Multivariate Logistic regression model was used to analyze the interaction between ApoA1/2 gene polymorphism and HDL-C level in cardiovascular death and all-cause death,and the interaction coefficient(γ)was used to analyze whether there was interaction between ApoA1/2 gene polymorphism and HDL-C level on cardiovascular death and all-cause death and the types of interaction.Results The difference on ApoA1-75G/A genotype and allele distribution between the two groups was statistically significant(P<0.05).HDL-C level in the death group was lower than that in the survival group,and the difference was statistically significant(P<0.05).The HDL-C level in patients with AA genotype of ApoA1-75G/A was higher than those in patients with GA genotype and GG genotype,and the differences between pairwise comparisons were statistically significant(P<0.05).GA and AA genotypes of ApoA1-75G/A and HDL-C were the influencing factors of cardiovascular death and all-cause death(P<0.05).The OR caused by the reduction of HDL-C alone was 5.691,the OR caused by the ApoA1-75G/A gene mutation alone was 0.400,and when the two existed at the same time,the OR of interaction was 5.333 andγwas 0.931,GA and AA genotypes of ApoA1-75G/A and the reduction of HDL-C lev

关 键 词：载脂蛋白A1/2 基因多态性 高密度脂蛋白胆固醇 老年冠心病 心血管死亡 全因死亡 交互作用 

分 类 号：R541.4[医药卫生—心血管疾病] R446.1[医药卫生—内科学]