前蛋白转化酶枯草溶菌素9基因rs529787位点多态性与血脂和缺血性脑卒中的关系研究

Correlation Between PCSK9 Gene rs529787 Polymorphism and Blood Lipid and Ischemic Stroke

目的探讨前蛋白转化酶枯草溶菌素9(PCSK9)基因rs529787位点多态性与脂代谢和缺血性脑卒中(IS)的关系。方法选取2012年7月—2015年7月到新疆医科大学第一附属医院神经内科就诊的IS患者414例为病例组,另选取同时期在本院进行体检的健康成年人350例为对照组。比较并分析两组的临床资料、基因型和等位基因分布情况。结果两组性别、年龄、民族、吸烟史、饮酒史、总胆固醇(TC)、载脂蛋白A_1(APOA_1)及载脂蛋白B(APOB)比较,差异无统计学意义(P>0.05);两组高血压和糖尿病合并情况、收缩压、舒张压、空腹血糖(FPG)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)及脂蛋白(a)〔Lp(a)〕比较,差异有统计学意义(P<0.05)。两组基因型分布比较,差异有统计学意义(P<0.05);两组等位基因分布比较,差异亦有统计学意义〔OR(95%CI)=1.763(1.038,2.994),P<0.05〕。对照组中,不同基因型受试者的TC、TG、LDL-C、HDL-C、APOA_1、APOB及Lp(a)比较,差异无统计学意义(P>0.05)。病例组中,不同基因型患者的TG、LDL-C比较,差异有统计学意义(P<0.05);而TC、HDL-C、APOA_1、APOB及Lp(a)比较,差异无统计学意义(P>0.05)。多因素非条件Logistic回归分析显示,高血压合并情况、收缩压、FPG、TG、LDL-C、HDL-C对IS的影响有统计学意义(P<0.05)。结论 PCSK9基因rs529787位点为CC基因型的IS患者血清TG和LDL-C水平较低,TG、LDL-C及HDL-C是IS的影响因素,携带等位基因C可能是IS的易患因素。

Objective To investigate the correlation between PCSK9 gene rs529787 polymorphism and blood lipid and ischemic stroke（ IS）. Methods From July 2012 to July 2015, we enrolled 414 IS patients who received treatment in Department of Neurology of the First Affiliated Hospital of Xinjiang Medical University,and we also enrolled 350 healthy adults who received physical examination in the same hospital as control group. Clinical data,genotype and allele distribution of the two groups were compared and analyzed. Results The two groups were not significantly different in gender,age,ethnic group,history of smoking,history of alcohol consumption, TC, APOA_1 and APOB（ P〈0. 05）; the two groups were significantly different in the combination of hypertension and diabetes,systolic pressure, diastolic pressure, FPG, TG, LDL-C, HDL-C and Lp（ a）（ P〈0. 05）. The two groups were significantly different in the distribution of genotype（ P〈0. 05）; the two groups were significantly different in allele distribution 〔OR（ 95% CI） = 1. 763（ 1. 038,2. 994）,P〈0. 05 〕. In control group,subjects with different genotypes were not significantly different in TC,TG,LDL-C,HDL-C,APOA_1,APOB and Lp（a）（P〈0. 05）. In case group,subjects with different genotypes were significantly different in TG and LDL-C（ P〈0. 05）,but were not significantly different in TC, HDL-C, APOA_1,APOB and Lp（a）（ P〈0. 05）. Multivariate unconditional Logistic regression analysis showed that complication with hypertension,systolic pressure,FPG,TG,LDL-C,HDL-C had significant influence on IS（ P〈0. 05）. Conclusion IS patients who have CC genotype at PCSK9 gene rs529787 locus have lower levels of serum TG and LDL-C,TG,LDL-C and HDL-C are influencing factors for IS,and allele C may be a susceptive factor for IS.