载脂蛋白E基因多态性及脂质代谢水平与胆囊结石形成的关系研究  

Correlation of apolipoprotein E gene polymorphisms and lipid metabolism levels with gallbladder stone formation

作　　者：任爱群 胡裕雯 叶红于 徐蓓蓓 戴显宁 叶毅 REN Aiqun;HU Yuwen;YE Hongyu;XU Beibei;DAI Xianning;YE Yi(Department of Gastroenterology,Wenzhou People's Hospital,Wenzhou 325000,China;不详)

机构地区：[1]温州市人民医院消化内科,325000 [2]温州市人民医院神经内科,325000 [3]温州市人民医院检验科,325000

出　　处：《浙江医学》2024年第14期1513-1517,共5页Zhejiang Medical Journal

基　　金：温州市基础性科研项目(Y2020289)。

摘　　要：目的探讨载脂蛋白(Apo)E基因多态性及脂质代谢水平与胆囊结石形成的关系。方法回顾性选取2022年6月至2023年6月在温州市人民医院诊断为胆囊结石的100例患者作为胆囊结石组,另选取同期在本院体检的100名健康者作为对照组。使用基因检测试剂盒进行多通道荧光定量分析Apo E基因多态性。比较两组Apo E基因型分布、等位基因频率分布以及血清TG、TC、HDL-C、LDL-C、非高密度脂蛋白胆固醇及脂蛋白水平差异。采用logistic回归分析胆囊结石形成的独立危险因素,采用ROC曲线评估危险因素对胆囊结石的预测效能。结果胆囊结石组患者TC、HDL-C、LDL-C水平均高于对照组(均P<0.05)。Apo E基因多态性分析显示,胆囊结石组ε2、ε4等位基因频率均高于对照组(均P<0.01)。胆囊结石组E2/3、E2/4、E3/4、E4/4及E2/4+E3/4+E4/4基因型频率均高于对照组(均P<0.01)。logistic回归分析显示,E2/3、E2/4及E3/4基因型、性别、HDL-C水平及吸烟史均是胆囊结石形成的独立危险因素(均P<0.05)。而E2/4、E3/4、TG、HDL-C可作为胆囊结石的预测指标,其联合预测的灵敏度为0.710,特异度为0.910,约登指数为0.620,截断值为0.600,AUC为0.880。结论胆囊结石患者存在Apo E基因多态性,且Apo E基因多态性、性别、HDL-C水平及吸烟史与胆囊结石的形成密切相关,E2/4、E3/4、TG、HDL-C可作为预测胆囊结石形成的潜在指标。Objective To explore the relationship of apolipoprotein E(Apo E)gene polymorphism and lipid metabolism levels with the formation of gallbladder stones.Methods A retrospective study was conducted by selecting 100 patients diagnosed with gallbladder stones from June 2022 to June 2023 at Wenzhou People's Hospital as the gallbladder stone group,and another 100 healthy individuals underwent physical examinations during the same period at the same hospital as the control group.Apo E gene polymorphism was analyzed with multi-channel fluorescent quantitative analysis using a gene detection kit.The distribution of Apo E genotypes,allele frequency distribution,and serum levels of TG,TC,HDL-C,LDL-C,non-HDL-C,and lipoprotein levels were compared between the two groups.Binary logistic regression analysis was used to analyze the independent risk factors for the occurrence of gallbladder stones,and the predictive efficacy of risk factors on the gallbladder stones was evaluated by ROC curve.Results Patients in the gallbladder stone group had higher levels of TC,HDL-C,and LDL-C compared to the control group(all P<0.05).Analysis of Apo E gene polymorphism revealed that the frequencies of theε2 andε4 alleles were higher in patients with gallbladder stones than those in the control group(both P<0.01).Furthermore,the frequencies of the genotypes E2/3,E2/4,E3/4,E4/4,and the combined genotype E2/4+E3/4+E4/4 were also increased in the gallbladder stone group(all P<0.01).Binary logistic regression analysis indicated that the genotypes E2/3,E2/4,and E3/4,gender,HDL-C levels,and smoking history were independent risk factors for the development of gallbladder stones(all P<0.05).The combined predictive factors of E2/4,E3/4,TG and HDL-C showed a sensitivity of 0.710,a specificity of 0.910,a Youden's index of 0.620,a cut-off value of 0.600,and an AUC of 0.880 for predicting gallbladder stones.Conclusion Apo E gene polymorphism exists in patients with gallbladder stones,the development of which is associated with Apo E gene polymorphism,gende

关 键 词：载脂蛋白E 基因多态性 胆囊结石 脂质代谢 

分 类 号：R575.62[医药卫生—消化系统]