武汉地区Ⅱ型糖尿病患者冠心病与载脂蛋白E基因型的关系

RELATION BETWEEN CORONARY HEART DISEASE AND APOLIPOPROTEINE GENOTYPE IN NIDDM PATIENTS IN WUHAN

应用聚合酶链反应（ＰＣＲ）技术，对随机选择的１２５例ＮＩＤＤＭ患者和５０例非ＤＭ患者进行ＡｐｏＥ基因型检测，以研究ＮＩＤＤＭ患者ＣＨＤ与ＡｐｏＥ基因型间的关系。结果表明，ＮＩＤＤＭ患者心肌梗塞和缺血性心电图改变在Ａｐｏε４／４和ε４／３型组中发生率分别为２１％和４１％，但不同基因型组间差异无显著性。心绞痛在Ａｐｏε４／４和ε４／３型组中为５２％，显著高于ε３／３型组（３１％，Ｐ＜０．０５）。Ａｐｏε４／４和ε４／３型ＮＩＤＤＭ患者，任何证据的ＣＨＤ发生率为７２％，显著高于ε３／３型组（３７％）及ε２／２、ε３／２型组（３３％，Ｐ＜０．０１）。ＮＩＤＤＭ患者中ＣＨＤ组Ａｐｏε３／３和ε４／３基因型频率分别为５２％和３４％，分别低于（ε３／３）、高于（ε４／３）非ＣＨＤ组（７１％，Ｐ＜０．０５；１０％，Ｐ＜０．０１）；ＣＨＤ组ε４等位基因频率为２１％，明显高于非ＣＨＤ组（７％，Ｐ＜０．０１）。提示Ａｐｏε４／４和ε４／３为ＮＩＤＤＭ患者ＣＨＤ的重要危险指标。

To study the relation between coronary heart disease and apolipoprotein E genotype in NIDDM patients in Wuhan, polymerasechain reaction(PCR)technique was used to determine apolipoprotein E genotype in 125 NIDDM patients and 50 non-diabetic pa-tients randomly selected.The results showed that the incidences of myocardial infarction and ischaemic electrocardiographic changesin the diabetic patients with the genotypese ε4/4 and ε4/3 were 21%and 41%respectively,though the difference between the geno-type groups was not significant.The incidence of angina pectoris was 52%in patients with genotype ε4/4 and ε 4/3,and was sig-nificantly higher than 31%in patients with genotype ε3/3 (P<0. 05).The incidence of coronary heart disease among the NIDDMpatients with the genotypesε4/4 and ε 4/3 was 72%,which was significantly higher than 37%in those with genotype ε 3/3,and33%in those with genotype ε 3/2(P<0.01).The frequencies of ε3/3 andε4/3 in CHD group were 52%and 34%respectively,the former being significantly lower than 71%of ε3/3(P<0. 05)and the latter being sig ficantly higher than 10%of ε4/3(P<0.05)in non-CHD group of diabetic patients respectively.The frequencv of ε4 allelc was 21%in CHD group,which was signifi-cantly higher than 7%in non-CHD group for diabetic population. Thus,the results suggest that the apolipoprotcin E genotypesε4/4 and ε4/3 can be considered as important risk indicators for coronary heart disease in NIDDM patients.