APOE基因多态性及其与环境因素的交互作用对颈动脉粥样硬化的影响

Effect of APOE gene polymorphism and its interaction with environmental factors on the risk of carotid atherosclerosis

目的:研究APOE基因多态性是否会影响颈动脉粥样硬化(CAS)的发病风险,以及APOE基因多态性与环境因素的交互作用对CAS发病风险的可能影响,以期为CAS的预防和治疗提供新的方向和个体化的方案。方法:入组332例(筛除ε2/4型),行Hardy-Weinberg检验,验证入组研究对象的基因型分布是否具有代表性。通过二元Logistic回归分析检验APOE基因多态性及其与环境因素的交互作用对CAS存在性的影响。结果:总样本人群的基因分布有代表性。E2、E3和E4组临床资料无明显差异。在总样本中,APOE基因多态性与CAS的发病风险无明显相关(P>0.05)。而按年龄和吸烟史分层分析后,在不吸烟男性中,校正血脂前后E2型的CAS发病风险均明显低于E3型(P=0.007,P=0.004),校正血脂前后E4型与E3型相比发病风险无明显差异(P=0.999)。在不吸烟女性和吸烟男性中,校正血脂前后均未发现APOE基因多态性对CAS发病风险的影响(P>0.05)。结论:在总人群中,APOE基因多态性与CAS发病风险无明显相关。不吸烟人群中,较之ε3,ε2对男性CAS的发病有保护作用而对女性无保护作用。在男性中,较之ε3,ε2对不吸烟者有保护作用而对吸烟者该保护作用不显著。

Objective:To investigate the effect of APOE gene polymorphism and its interaction with environmental factors on the risk of carotid atherosclerosis(CAS),and to provide new directions and an individualized therapeutic approach for the prevention and treatment of CAS.Methods:Three hundred and thirty-two subjects(exclucingε2/4 genotype)were enrolled in this study.Hardy-Weinberg principle was employed to test the representativeness of subjects’genotype distribution.The effects of APOE gene polymorphism and its interaction with environmental factors on the risk of CAS were examined by binary logistic regression analysis.Results:The representativeness of genotype distribution of the subjects was confirmed.Clinical data of E2,E3 and E4 groups did not show significant differences.Among all subjects,APOE gene polymorphism was not significantly associated with the risk of CAS(P>0.05).After stratifying all subjects by age and smoking history,the risk of CAS in E2 group was significantly lower than that in E3 group(P=0.007,P=0.004)in male non-smokers before and after adjusting the blood lipid levels,while there was no significant difference in the risk of CAS between E4 and E3 groups(P=0.999).Among non-smoking women and smoking men,the effect of APOE gene polymorphism on the risk of CAS was not found before and after adjusting blood lipid levels(P>0.05).Conclusion:APOE gene polymorphism does not have significant influence on the risk of CAS.Among non-smokers,ε2 has a protective effect upon the risk of CAS in males but not in females as compared withε3.In males,ε2 has a protective effect on the risk of CAS in non-smokers compared withε3,but the effect is not significant in smokers.