血管紧张素1转化酶基因多态性与Ⅱ型糖尿病合并心肌梗死的关系

Relationships between ACE Gene Polymorphism and Myocardial Infarction in Chinese Type 2 Diabetes

为探讨血管紧张素 1转化酶 (ACE)基因插入 /缺失多态性与Ⅱ型糖尿病合并心肌梗死 (MI)及无并发症的Ⅱ型糖尿病 (DM2 )的相关情况 ,同时观察血清ACE水平与ACE基因多态性及疾病的关系。对 82例MI、86例DM2和 84例健康人 (对照组 )用PCR方法进行了ACE基因内含子 1 6插入 /缺失多态性的检测 ,用紫外分光光度法测定了血清ACE水平。结果MI组D等位基因频率 0 .52 ,DD基因型频率 0 .32 ,与对照组 ( 0 .36,0 .1 5)比较有显著差异 (P <0 .0 5) ,DD基因型对MI的比数比为 3.0 1 ( 95%可信区间为 1 .2 8～ 7.0 4 ,P <0 .0 1 ) ;DM2组基因型频率分布与对照组比较无显著差异 (P >0 .0 5) ;各组中DD基因型个体血清ACE水平最高 ,II基因型最低 ,基因多态性与血清ACE水平呈相关性 (r=0 .65,P <0 .0 1 )。说明ACE基因缺失多态性参与中国人DM2合并MI的发病 。

The study is to investigate whether the insertion/deletion polymorphism of angiotensin 1 converting enzyme (ACE) gene is associated with Type 2 diabetes mellitus without cardiovascular complications (DM2) and that with myocardial infarction (MI) in Chinese, and to ascertain the interaction of serum ACE levels and ACE gene polymorphism to the development of the associated diseases. ACE genotypes of 82 cases with MI, 86 with DM2 and 84 controls were determined by polymerase chain reaction (PCR). Serum ACE levels were measured with ultraviolet photometry. The increased frequencies of D allele(0.52) and DD genotype (0.32) were respectively observed in 82 subjects with MI compared with 84 control subjects(0.36,0.15 respectively, P <0.05). The odds ratio associated with DD/II genotype was 3.01(95%CI 1.28～7.04, P <0.01) for MI. Individuals with DD genotype had the highest serum ACE in all groups, and with II genotype the lowest levels. There was no difference in allele distribution between 86 DM2 patients and the controls. ACE gene polymorphism is associated with serum ACE levels( r = 0.65 , P <0.01). Deletion polymorphism of the ACE gene contributes to the development of myocardial infarction and is a risky factor for MI in Chinese type 2 diabetes.