血小板反应素-1基因G1678A多态性与急性冠脉综合征的相关性

Relationship between thrombospondin-1 gene G1678A polymorphism and acute coronary syndrome

目的探讨血小板反应素-1（thrombospondin-1，TSP-1）基因G1678A（Ala523Thr）多态性与中国汉族人群急性冠脉综合征（ACS）的可能关系。方法采用病例对照研究，病例均选自2003年11月至2006年5月在江苏大学附属武进医院等4家医院住院的患者，其中ACS患者412例，病例均符合2002年AHA／ACC关于ACS诊断指南的诊断指标；同期选择年龄、性别相匹配的经相关检查排除冠心病者319例为对照。应用聚合酶链反应-限制性片段长度多态性（PCR-RFLP）方法检测TSP-1 G1678A多态性。结果ACS患者3SP-1 G1678A多态性AA基因型频率（49，5％）明显高于对照组（40．4％），两组差异有统计学意义（P=0．015）。GA和GG基因型在ACS组和对照组的分布差异无统计学意义（GA：39．3％VS．46，1％，P=0．070；GG：11．2％VS．13．5％，P=0．340）。A等位基因频率在ACS组和对照组分别为69．2％、63．5％（P：0．022）。多元logistic回归分析显示，TSP-1基因AA基因型与ACS的发生具有显著相关性（OR=1．52；95％ CI：1．11～2．08；P=0．010）。结论TSP-1基因G1678A多态性勺中国汉族人群ACS密切相关，AA基因型可能是ACS遗传易感性的基因标记之一。

Objective To investigate the possible association between the thrombospondin-1 （TSP-1） gene G1678A （Ala523Thr） polymorphism and acute coronary syndrome （ACS） in a Chinese Han population. Method The case cohort studied was composed of 412 hospitalized patients with ACS recruited from four participating hospitals between November 2003 and May 2006. The diagnosis of ACS was based on the criteria of AHA/ACC set in 2002. The control group was consisted of 319 age- and sex-matched subjects from participating hospitals, and they were free from coronary ＇artery disease judged by history, clinical examination, electrocardiography, exercise test and angiography. The TSP-1 G1678A polymorphism was determined by polymerase chain reaction and restriction fragment length polymorphism analysis（ PCR-RFLP）. Results The prevalence of AA genotype of the G1678A polymorphismin patients with ACS was significantly higher than that in the control subjects （49.5%% vs. 40.4%, P = 0.015）. The frequencies of GA and GG genotypes were not significantly different between patients with ACS and controls （GA： 39.3% vs. 46.1%, P = 0.070; GG： 11.2% vs. 13.5%, P = 0.340）. The frequencies of A .allele in the ACS group and control group were 69.2% and 63.5%, respectively （P = 0. 022）. Furthermore, multiple logistic regression analysis showed that the AA genotype was a significant risk factor for ACS （ OR = 1.52; 95% CI： 1.11 - 2.08 ; P = 0. 010）. Conclusions The present findings suggest that the AA genotype in TSP-1 gene G1678A polymorphism may be associated with a risk factor for ACS in the Han nationality of China. The AA genotype may be a genetic marker of the liability to the inheritance of ACS.