痛风遗传易感基因及相关危险因素的病例对照研究

Case-control study on the genes with genetic susceptibility and relative risk factors in gout patients

目的了解痛风遗传易感基因及相关危险因素，为痛风预防控制措施的制定提供科学依据。方法采用1：l配对病例对照研究的方法，于2008年2—12月，在山东省随机选取5家医院内科门诊确诊的痛风患者作为病例，同时，选取年龄相近、同民族、同县（市）、同一时间在该医院内科门诊就诊的胃肠炎患者作为对照，共调查95对病例对照，进行问卷调查、生化指标测定和基因多态性检测，并进行多因素条件logistic回归分析。结果多因素条件logistic回归结果表明，直系亲属患高尿酸血症者（OR=44．142，95％CI：5．832～334．095），喝啤酒量较大（OR=1．539，95％CI：1．017～2．732），经常吃蛤蜊（OR=2．256，95％CI：1．206—4．220），总胆固醇水平高（OR=I．793，95％CI：1．010—3．183），ApoAI—CⅢ-AIV基因簇-75位点A等位基因（OR：1．937，95％CI：1．001～4．983），ApoAI—CIn—AIV基因簇＋83位点T等位基因（OR=1．891，95％CI：1．011～3．537），ApoAI—CⅢ-AIV基因簇XmnI位点突变型等位基因X2（OR=4．417，95％CI：2．211．8．822）的频率升高是痛风发生的危险因素。结论痛风的危险因素涉及饮食、血脂指标和遗传基因多态性多个方面，应制定综合防控措施，预防痛风的发生。

Objective To Understand the genes with genetic susceptibility and relative risk factors in gout patients and to provide the scientific basis for prevention and control measures of gout. Methods The gout cases from 5 hospitals in Shandong Province were investigated with 1：1 matched case-control study during February 2008 to December 2008. The patients with gastroenteritis were served as control group according to similar age, same race and area at the same time. The questionnaire, biochemical test and genetic polymorphism test were used to investigate 95 cases and controls. The data were analyzed with multiple logistic regression analysis. Results The results of multiple logistic regression analysis indicated that the risk factors of gout were the direct relatives with hyperuricemia （HUA） （OR=44.142, 95%CI： 5.832-334.095）, beer drinkers （0R=1.539, 95%CI： 1.017-2.732）, patients with eating clams （OR=2.256, 95%CI： 1.206-4.220）, patients with high TC （OR=1.793, 95%C1：1.010-3.183）, patients with high frequencies of ApoAI-C III-AIV gene cluster-75 allele A （OR=1.937, 95% CI： 1.001-4.983）, ApoAI-C II-AIV gene cluster＋83 allele T（OR=l.891, 95%CI： 1.011-3.537） and ApoAI-C III-AIV gene cluster Xmn I mutant allele X2（OR=4.417, 95%CI： 2.211- 8.822）. Conclusion The risk factors of gout are involved in diet, serum lipid and genetic polymorphisms. The prevention and control measures should be instituted for gout.