脂蛋白脂酶基因S447X变异对高血压病患者肥胖与血脂关系的影响

Relationship of obesity and serum lipids in essential hypertensives with lipoprotein lipase S447X variants

目的 探讨脂蛋白脂酶 (LPL)基因S4 4 7X变异对高血压病 (EH)患者肥胖与血脂关系的影响。方法 选择上海社区 2周内未服用任何抗高血压药物的EH患者 983例 ,按体重指数水平分为肥胖组和体重正常组 ,应用PCR RFLP技术检测LPL S4 4 7X多态性。结果 肥胖组和体重正常组S4 4 7X基因型构成及等位基因频率差异无统计学意义 ;肥胖组甘油三酯 (TG)和Log(TG/HDL C)显著高于体重正常组 ,高密度脂蛋白胆固醇 (HDL C)水平显著低于体重正常组。按基因型分层后 ,在S4 4 7S基因型 ,肥胖组TG和Log(TG/HDL C)仍显著高于体重正常组 ,HDL C水平仍显著低于体重正常组 ;但在X4 4 7等位基因携带者 ,肥胖组和体重正常组血脂谱水平差异无统计学意义。进一步按年龄 <5 0岁和年龄≥ 5 0岁分组后 ,此种效应仅出现在高年龄组 ,且肥胖者X4 4 7等位基因携带者HDL C水平及Log(TG/HDL C)与体重正常组各基因型的相似。LPL S4 4 7X变异和肥胖对高年龄组HDL C和Log(TG/HDL C)存在交互作用 ,有统计学意义。结论 LPL S4 4 7X变异和肥胖对高年龄组HDL C和Log(TG/HDL C)具有交互作用 ,表明S4 4 7X变异调整EH肥胖者的血脂水平。

Objective To investigate the impact of the lipoprotein lipase (LPL) S447X variants on the relationship between obesity and serum lipids in essential hypertensives. Methods Nine hundred and eightythree hypertensive patients were selected from communities of Shanghai, who had not been treated with antihypertensive medications at least for two weeks before blood collection. LPL S447X polymorphisms were determined by polymerase chain reaction (PCRRFLP). Results The allele and genotype frequencies for LPL S447X polymorphisms were similar in obese group and normal weight subjects. Serum triglycerides (TG) levels and mean Log TG/high density lipoprotein cholesterol (HDLC) ratio were significantly higher in obese group than in normal weight subjects, whereas HDLC was significantly lower in obese group in both genders. In S447, after stratification for genotype, serum TG and Log TG/HDLC were still higher and HDLC was lower in obese group. However, for X447 carriers, there were no significant differences in these lipid traits. Furthermore, upon stratification for age (<50 vs. ≥50), these effects existed only in the older age groups. Mean HDLC value and mean Log TG/HDLC ratio of the obese X447 carriers were similar to that of normal weight subjects with different genotypes. A statistically significant interaction between obesity and LPL S447X variants was observed for HDLC level and Log TG/HDLC ratio in the older age groups. Conclusion These results indicate that LPL S447X variants influence the relationship between obesity and serum lipoprotein lipid in patients with essential hypertension.