哈萨克族高血压的环境与遗传危险因素的交互作用

Interaction Between Genetic and Environmental Risk Factors on Essential Hypertension in Kazakh Population

目的探讨哈萨克族高血压的环境和遗传危险因素及其交互作用。方法通过现场问卷调查和体格检查获取个人基本资料,在此基础上,选择573例无血缘关系个体,高血压261人(男/女=111/150),平均年龄52.16±12.38岁;对照组312人(男/女=121/191),平均年龄40.91±14.27岁。通过病例-对照相关分析,应用聚合酶链反应(PCR)鉴定血管紧张素转换酶(ACE)基因插入/缺失多态性的频率分布;应用Logistic回归模型分析遗传与环境因素的交互作用。结果 (1)血脂测定显示,高血压组血清TG,TC,Apo-A,Apo-B,肌酐和尿酸水平明显高于对照组(P<0.05);而HDL-C低于对照组(P=0.0145)。(2)以ACE基因的DD基因型为参照,ID基因型的OR为1.200(95%Ci=0.789-1.825,P=0.3947)。(3)多因素Logistic回归分析结果表明,年龄、BMI和ACE基因都进入回归模型,明显增加高血压的危险性(P<0.05),Apo-A与BMI和ACE基因型存在交互作用。结论本文研究结果表明,年龄、肥胖(BMI>24kg/m^2)和高血脂是哈萨克族高血压的重要环境危险因素;ACE基因Ⅱ基因型和Ⅰ等位基因可大大增加高血压的危险性。

Objective To explore the interaction between the genetic and environmental risk factors of essential hypertension in a Chinese Kazakh population. Methods All of basic data were obtained from those subjects by questionare and standardized physical exami- nation. Total 573 subjects without blood relationship each other were selected, including 261 hypertasives （M/F = 111/150, mean aged 52.16-＋ 12.38 years）and 312 normotensives （M/F = 121/192,mean aged 40.99 -＋ 14.27 years） as a case -control association study. The genotype of the insetion/delection （I/D） polymorphism of angiotension - converting enzyme gene was performed using polymerase chain （PCR）. The interaction between the genetic and environmental risk factors and the incidence of essential hypertension was assayed by multivariate logistic regression analysis. Results （ 1 ） The levels of TG, TC, APO - A, APO - B, UA and Cr were significantly higher in hypertensives than those in controls（ P 〈 0.05）. However, the level of HDI, - C was lower in hypertensive than that in controls（ P = 0. 0145） ; （2） Multivariate logistic regression analysis showed that age, high level of TG, TC and overweight or obesity were the risk fac- tors of hypertension ; （3） With DD genotype as a reference, the relative risk of the subjects with II genotype was 1.2 fold （ OR = 1. 200, 95% CI =0. 789 ~ 1. 825） with DD genotype. There was the interaction between Apo - A,BMI and the polymorphism of ACE gene. Con- clusion Age, overweight or obesity, high level of TG, TC are the risk factors and the II genotype of ACE gene can increase the risk of hypertension in Chinese Kazakh population.