血管紧张素转化酶基因多态性与高血压病人胰岛素抵抗相关性的研究  

The ACE DD Genotype is Associated with Insulin Resistance in Chinese

作　　者：林金秀[1] 叶琼[1] 吴可贵[1] 曾开淇[1] 郑舒亮[1] 

机构地区：[1]福建医科大学附属第一医院心内科福建省高血压研究所,福建福州350005

出　　处：《高血压杂志》2002年第6期540-542,共3页Chinese Journal of Hypertension

基　　金：福建省自然科学基金资助 (C9810 0 32 )

摘　　要：目的　探讨血管紧张素转化酶 (ACE)基因多态性 ,血管紧张素原 (AGT)基因突变与高血压及胰岛素抵抗的关系。方法　用聚合酶链反应 (PCR)检测 76例原发性高血压及 2 8例正常血压者的ACE基因插入 /缺失 (I/D)多态性及AGT基因位点突变 ,同时进行口服葡萄糖耐量及胰岛素释放试验 ,以空腹血糖及空腹胰岛素乘积倒数的对数值(ISI) ,胰岛素曲线下面积IS AUC作为胰岛素敏感性指标。结果　 (1)ACE基因多态性在高血压和正常血压组无显著性差异 ,而AGTT2 35等位基因频率在高血压组高于正常对照组 (0 4 3vs0 32 ,P <0 0 5 )。 (2 )无论是高血压还是正常血压者ACE基因DD型者的ISI均明显低于ID和II型 ,IS AUC显著高于ID和II型〔ISI:- 4 31± 0 2 0vs -3 6 3± 0 2 2和 - 3 2 7± 0 2 4 ,P <0 0 1;IS(AUC) :2 11 1± 5 6 8vs 135 7± 5 4 7、12 6 8± 5 1 7mu·L-1,P <0 0 1〕 ,而AGT基因T2 35 ,T174基因突变与胰岛素抵抗无关 (P >0 0 5 )。结论　ACE基因DD型而非AGT基因可能参与高血压病人及正常血压者胰岛素抵抗的基因调节 。Objective The association between angiotensin converting enzyme(ACE) gene polymorphism, angiotensinogen(AGT) gene and insulin resistance(IR) in hypertensive subjects remains controversial. Thus, we investigated the association between ACE and AGT genotypes and IR in Chinese population. Methods We enrolled 76 hypertensive patients(EH) and 28 normotensive subjects(NS), A PCR assay was used to identify ACE and AGT genotypes, insulin sensitivity index(ISI) and area under insulin curve (IS AUC) were the index of insulin sensitivity. Results (1) T235 allele freguency of AGT is higher in EH than that in NS (0 43 vs 0 32, P <0 05), ACE genotypes did not differ significantly between EH and NS.(2)ISI were significantly lower in subjects with the ACE DD genotype compared to those with the ID and II genotypes in EH (-4 66±0 21 vs -3 87±0 27 and -3 76±0 25, P <0 01), and NS (-4 08±0 16 vs -3 14±0 19 and -3 08±0 18, P <0 01) These homozygous DD subjects also had higher IS AUC compared to those with the ID and II genotypes in EH (227 6±53 7 vs 161 3±15 4 and 143 6±51 8 mu·L -1 , P <0 01) and NS (156 4±31 3 vs 87 2±29 4 and 80 1±27 3 mu·L -1 , P <0 01). No significant association between AGT genotypes and ISI or IS AUC were observed in EH or NS. Conclusion ACE DD genotype, but not the AGT gene may be involved in the genetic regulation of insulin sensitivity in both hypertensive and normotensive Chinese subjects, this may help to explain the reported associated between the D allele and cardiovascular complications.

关 键 词：血管紧张素转化酶 基因多态性 原发性高血压 胰岛素抵抗 EH 

分 类 号：R544.1[医药卫生—心血管疾病]