海南黎族血管紧张素转换酶基因多态性与高血压并动脉硬化的相关性研究

Study on the correlation between angiotensin converting enzyme gene polymorphism and hypertension accompanying atherosclerosis in Li people in Hainan province

目的探讨海南黎族人群血管紧张素转换酶（ACE）基因多态性与高血压并动脉硬化的相关性。方法采用聚合酶链反应（PCR）检测260例海南黎族动脉硬化患者组及276例黎族健康人对照组的ACE基因插入或缺失（I／D）多态性，观察DD、DI、II基因型频率及等位基因频率。用高分辨超声技术分别检测DD、DI、II3个亚组的平均颈动脉内-中膜厚度（MIMT）。结果（1）动脉硬化组DD、DI、II基因型频率为15．0％、37．3％、47．7％；D及I等位基因频率分别为33．7％及66．3％。对照组DD、DI、II基因型频率17．8％、40．6％、41．7％，D及I等位基因频率分别为38．0％及62．0％。两组间DD、DI、II基因型频率及D、I等位基因频率差异无统计学意义（P〉0．05）。（2）动脉硬化组在年龄、总胆固醇（TC）、三酰甘油（TG）、载脂蛋白A（apoA）、载脂蛋白B（apoB）、收缩压、舒张压显著高于对照组（P〈0．05），而高密度脂蛋白胆固醇（HDL-C）显著低于对照组（P〈0．05）；Logistic回归分析结果显示，TG（OR=2．14）、apoA（OR=360．39）、收缩压（OR=1．21）、舒张压（OR=1．08）、ACEDD基因型（OR=0．30）与高血压并动脉硬化相关（P〈0．05）。ACEDD型亚组的MIMT比DI和II型亚组显著增高（P〈0．05）。结论ACEDD基因型增加了颈动脉硬化易感性，是海南黎族高血压并动脉硬化患者的危险因素，可作为动脉粥样硬化的一个早期预测因子．

Objective To explore the correlation between angiotensin converting enzyme （ACE） gene polymorphism and hypertension accompanying atherosclerosis in Li people in Hainan province. Methods Two hundred and sixty patients with hypertension accompanying atherosclerosis were selected as hyper：cension plus atherosclerosis group, while two hundred and seventy-six healthy people were regarded as healthy control group. ACE I/D gene polymorphism was detected by polymerase chain reaction （PCR）, and the genotype frequencies and allele frequencies of DD, DI and II were investigated. The carotid intimal-medial thickness （IMT） was measured by high-resolution ultrasound technique and mean IMT （MIMT） was calculated. Results （1） In the hypertension plus atherosclerosis group, the genotype frequencies of DD, DI and II were 15.0%, 37.3%, 47.7%, respectively, and the allele frequencies of D and I were 33.7% and 66.3% ,respectively. In the healthy control group, the genotype frequencies of DD, DI and II were 17.8% , 40.6% and 41.7%, respectively, and the allele frequencies of D and I were 38.0% and 62.0%, respectively. There were no significant differences both in the genotype frequencies of DD, DI and II, and in allele frequencies of D and I between the two groups （P〉0.05）. （2） The age, total serum cholesterol（TC）, triglyceride （TG） ,systolic pressure（SBP） ,diastolic pressure（DBP）, apolipoprotein A（apoA） and apolipoprotein B （apoB） levels were significantly higher in the hypertension plus atherosclerosis group than in the control group（P〈0.05）. The high density lipoprotein cholesterol（HDL C） level was significantly lower in the hypertension plus atherosclerosis group than in the control group（P〈0.05）. Logistic regression analysis showed that TG （OR= 2.14）, apoA（OR=360.39）, SBP（OR=1.21）, DBP （OR= 1.08） and ACE DD genetype （OR =0. 30） had correlation with hypertension plus atherosclerosis（all P〈0.05）. The MIMT level was significantly higher in ACE DD subset than in DI and II subset （P〈0.05）. Conclusions The ACE DD genotype increases the susceptibility of carotid atherosclerosis, which is the risk factor for hypertension accompanying atherosclerosis in Li people in Hainan province. It may be an early predictive factor in atheroselerosis.