邯郸地区汉族人群酰基辅酶A：胆固醇酰基转移酶1位点rs1044925基因多态性与冠心病患者血脂代谢的相关性研究

Correlation between ACAT-1 rs1044925 Gene Polymorphism and Blood Lipid Metabolism of Patients with Coronary Heart Disease in Han Population in Handan

目的探究酰基辅酶A:胆固醇酰基转移酶1(ACAT-1)位点1044925基因多态性与冠心病患者血脂代谢的相关性。方法选取2015年邯郸市第一医院心内一科收治的冠心病住院患者396例作为冠心病组,另选择同期冠状动脉造影检查正常者428例作为对照组。采用聚合酶链反应-限制性片段长度多态性分析法(PCR-RFLP)对两组患者ACAT-1位点rs1044925基因多态性进行分析。比较两组受试者体质指数(BMI)、血脂指标、ACAT-1位点rs1044925基因型及等位基因分布情况,分别比较两组不同基因型受试者血脂指标。结果冠心病组患者BMI及血清三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、非高密度脂蛋白胆固醇(n HDL-C)、脂蛋白(a)水平均高于对照组,血清高密度脂蛋白胆固醇(HDL-C)水平低于对照组(P<0.05);两组受试者血清载脂蛋白A_1(ApoA_1)、载脂蛋白B(Apo B)水平比较,差异无统计学意义(P>0.05)。两组受试者基因型和A、C等位基因分布情况比较,差异均无统计学意义(P>0.05)。对照组不同基因型受试者血清TC、TG、LDL-C、nHDL-C、LDL-C、ApoA_1、Apo B及脂蛋白(a)水平比较,差异均无统计学意义(P>0.05)。冠心病组不同基因型患者血清TC、TG、nHDL-C、ApoA_1、Apo B及脂蛋白(a)水平比较,差异均无统计学意义(P>0.05);AA基因型患者血清HDL-C水平低于AC/CC基因型患者,血清LDL-C水平高于AC/CC基因型患者(P<0.05);采用协方差分析校正性别、年龄和BMI,结果显示冠心病组AA基因型患者血清HDL-C水平低于AC/CC基因型患者,血清LDL-C水平高于AC/CC基因型患者(P<0.05)。结论邯郸地区汉族人群ACAT-1位点rs1044925基因多态性与冠心病患者血清LDL-C和HDL-C水平有关,ACAT-1位点rs1044925基因多态性可能通过影响血脂代谢而参与冠心病的发生和发展。

Objective To investigate the correlation between ACAT-1 rsl044925 gene polymorphism and blood lipidmetabolism of patients with coronary heart disease in Han population in Handan. Methods In 2015 in the First Department ofCardiology, the First Hospital of Handan, a total of 396 inpatients with coronary heart disease were selected as case group, atotal of 428 subjects with normal coronary arteriography examination results were selected as control group. PCR - RFLP was usedto analyze the gene polymorphism of ACAT-1 rsl044925. BMI, blood lipids index, gene types and allele distribution of ACAT-1rs l044925 were compared between the two groups; blood lipids index was compared in patients and subjects with different genetypes. Results BMI, serum levels of TG, TC, LDL-C, nHDL-C and lipoprotein （ a ） of case group were statisticallysignificantly higher than those of control group, while serum HDL-C level of case group was statistically significantly lower than that of control group （ P 〈 0.05 ） ; no statistically significant differences of serum level of ApoAj or ApoB was found between thetwo groups （ P 〉 0. 05 ）. No statistically significant difference of gene type, A allele distribution or C allele distribution wasfound between the two groups （ P 〉 0. 05 ） . Of control group, no statistically significant differences of serum level of TC, TG,LDL-C, nHDL-C, LDL-C, ApoAj , ApoB or lipoprotein （ a） was found in subjects with different gene types （ P 〉 0.05 ） . Ofcase group, no statistically significant differences of level of TC, TG, nHDL-C, ApoAj , ApoB or lipoprotein （ a ） was found inpatients with different gene types （ P 〉 0. 05 ） ; serum HDL-C level of patients with AA gene type was statistically significantlylower than that of patients with AC gene type or CC gene type, respectively, while serum LDL-C level of patients with AA genetype was statistically significantly higher than that of patients with AC gene type or CC gene type, respectively （ P 〈0. 05） ; aftercorrection of gender, age and BMI, covariance analysis results showed that, serum HDL-C level of patients with AA gene typewas statistically significantly lower than that of patients with AC gene type or CC gene type, respectively, while serum LDL-Clevel of patients with AA gene type was statistically significantly higher than that of patients with AC gene type or CC gene type,respectively （ P 〈 0. 05 ） . Conclusion Gene polymorphism of ACAT-1 rsl044925 is correlated with serum levels of LDL-C andHDL-C of patients with coronary heart disease in Han population in Handan, it may play an important role in the genesis anddevelopment of coronary heart disease through influencing the blood lipid metabolism.