摘要
目的 明确体质量指数（BMI）与华法林稳定剂量的相关性，并分析BMI与基因型对华法林剂量的交互作用。方法 前瞻性募集解放军总医院自2010年1月至2014年12月连续收治的首次接受华法林抗凝治疗并达到稳定抗凝的患者427例，采集抗凝相关基线和临床数据。利用Pearson相关以及多元线性回归分析BMI与华法林稳定剂量的独立相关性，应用广义线性模型分析BMI和基因型交互作用对华法林稳定剂量的影响。结果 华法林稳定剂量与BMI呈正相关（B＝0.47，95% CI：0.30～0.63，P＜0.001）。BMI每增加一个单位，华法林周剂量增加0.40mg。利用方程式：10.47＋0.40×BMI 能够预测华法林稳定治疗的周剂量。根据基因型进行分层后发现，携带相关基因型CYP2C9＊3和VKORC1-1639G＞A的患者BMI与华法林稳定剂量依然呈正相关（r：0.23～0.37，P＜0.05）， 基因型和BMI之间对华法林剂量的影响无交互作用（PCYP2C9×BMI＝0.87，PVKORC1×BMI＝0.58）。结论 BMI和华法林稳定治疗剂量之间呈正相关，且不受基因型影响，BMI与基因型共同影响华法林的稳定治疗剂量。
Objective To illustrate the correlation of body mass index （BMI） with stable dose of warfarin, and analyze the interaction between BMI and genotypes on warfarin dose. Methods A total of 427 consecutive stable anti-coagulated patients taking warfarin for the first time were recruited prospectively in our hospital from January 2010 to December 2014. Anticoagulant treatment related baseline and clinical data were collected. The correlation between weekly stable dose of warfarin and BMI was analyzed with Pearson correlation and multivariate linear regression analyses. The interaction between BMI and genotypes on the stable dose was analyzed with generalized linear model. Results BMI was positively correlated with the stable dose of warfarin （B=0.47, 95%CI： 0.30？0.63, P〈0.001）. The average dose of warfarin was increased by 0.40mg as BMI increasing by 1 unit. The equation of 10.47±0.40×BMI could predict the average weekly dose of warfarin. After stratified by genotypes, a positive correlation was found between BMI and stable warfarin dose among the CYP2C9＊3 and VKORC1-1639G〉A carriers （r： 0.23 to 0.37, P〈0.05）. There was no interaction between genotype and BMI （PCYP2C9×BMI=0.87, PVKORC1×BMI=0.58） on warfarin dose. Conclusion There is a positive correlation between BMI and stable dose of warfarin, which is not affected by genotypes. BMI and genotypes could influence warfarin stable dose collaboratively.
出处
《中华老年多器官疾病杂志》
2016年第1期1-5,共5页
Chinese Journal of Multiple Organ Diseases in the Elderly
基金
北京市自然科学基金面上项目（7152129）
解放军总医院临床扶持基金（2012FC-TSYS-3043）
