肾上腺素β受体基因、G蛋白基因和CYP2D6基因多态性对美托洛尔导致脂代谢异常的影响  

Effects of Gene Polymorphism of AdrenalineβReceptor Gene,G Protein Gene and CYP2D6 Gene on Abnormal Lipid Metabolism Induced by Metoprolol

作　　者：刘泽[1] 郝言[1] 张薇[1] 徐辉 LIU Ze;HAO Yan;ZHANG Wei;XU Hui(Dept.of Pharmacy,Beijing Youan Hospital Affiliated to Capital Medical University,Beijing 100069,China;Center for Integrated Chinese and Western Medicine,Beijing Youan Hospital Affiliated to Capital Medical University,Beijing 100069,China)

机构地区：[1]首都医科大学附属北京佑安医院药学部,北京100069 [2]首都医科大学附属北京佑安医院中西医结合中心,北京100069

出　　处：《中国医院用药评价与分析》2023年第6期693-695,700,共4页Evaluation and Analysis of Drug-use in Hospitals of China

基　　金：北京市医院管理局北京市属医院科研培育计划项目(No.PX2019028)。

摘　　要：目的:研究肾上腺素β受体基因、G蛋白基因和CYP2D6基因多态性对美托洛尔导致脂代谢异常的影响。方法:选取2019年10月至2022年10月该院收治的初治高血压患者120例,检测β_(1)受体基因Ser49Gly、Gly389Arg多态;β_(2)受体基因Arg16Gly、Gln27Glu多态;β3受体基因Trp64Arg多态;代谢酶基因CYP2D6*10的P34S多态;G蛋白基因GNB3 C825T多态。比较美托洛尔单药治疗3个月后不同表型总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白(LDL)和高密度脂蛋白(HDL)水平变化。结果:各基因位点不同基因型患者的年龄、性别、体重指数、基线TC和基线TG等指标比较,差异均无统计学意义(P>0.05)。治疗3个月后,β_(2)肾上腺素受体基因Arg16Gly患者的TG水平升高,其中Gly/Gly型患者升高幅度最高,Arg/Gly型次之,二者均高于Arg/Arg型,差异有统计学意义(P<0.05)。结论:β_(2)肾上腺素受体Arg16Gly多态与美托洛尔引起的血浆TG水平升高相关,携带2个G等位基因会导致服药后血脂水平明显升高。OBJECTIVE:To probe into the effects of gene polymorphism of adrenalineβreceptor gene,G protein gene and CYP2D6 gene on abnormal lipid metabolism induced by metoprolol.METHODS:A total of 120 patients with hypertension admitted into this hospital from Oct.2019 to Oct.2022 were selected as research objects,so that theβ_(1)receptor gene Ser49Gly and Gly389Arg polymorphism,β_(2)receptor gene Arg16Gly and Gln27Glu polymorphism,β3 receptor gene Trp64Arg polymorphism,P34S polymorphism of metabolic enzyme gene CYP2D6∗10 and G protein gene GNB3 C825T polymorphism were detected.Changes of total cholesterol(TC),triacylglycerol(TG),low density lipoprotein(LDL)and high density lipoprotein(HDL)levels in different phenotypes after 3 months of metoprolol monotherapy were compared.RESULTS:There was no statistical significance in differences in age,gender,body mass index,baseline TC and baseline TG among patients with different genotypes at each genetic locus(P>0.05).After 3 months of treatment,TG levels were elevated in patients with theβ_(2)adrenergic receptor gene Arg16Gly,with the highest elevation in patients of Gly/Gly type and the second highest of Arg/Gly type,both were higher than Arg/Arg type,with statistically significant differences(P<0.05).CONCLUSIONS:Theβ_(2)adrenergic receptor Arg16Gly polymorphism is associated with elevated plasma TG level caused by metoprolol,and carrying two G alleles leads to a significant increase in blood lipids after taking the drug.

关 键 词：基因多态性 美托洛尔 血脂 三酰甘油 Β2肾上腺素受体 

分 类 号：R972[医药卫生—药品]