线粒体基因位点G12630A与冠心病患者他汀类药物诱导的肌痛相关

Mitochondrial G12630A variation is associated with statin-induced myalgia in Chinese patients with coronary artery disease

目的探索确定与瑞舒伐他汀诱导的肌痛相关的线粒体基因变异位点。方法对403例服用瑞舒伐他汀及双联抗血小板药物(DAPT)的冠心病患者进行GSA基因芯片检测,其中341人具有完整的肌痛相关随访信息,389人测得肌酸激酶(CK)水平。首先采用logistic回归模型评估69个线粒体基因变异位点与341名肌病患者的相关性,最后通过线性回归模型依次评估这些变异位点对389名患者肌酸激酶水平的影响。结果线粒体G12630A变异与肌痛风险增加有关(OR:8.689;95%CI:1.586-47.6;P=0.01),但不同G12630A基因型患者肌酸激酶水平无显著性差异(P>0.05)。而CK水平与T12285C、A13105G的相关性有统计学意义(P<0.05)。结论线粒体基因位点G12630A与他汀类药物诱导的肌痛相关,这为临床上对于携带该风险等位基因的患者采取不同的治疗策略提供了理论基础。

Objective To identify mitochondrial gene variants associated with statin-induced myalgia in Chinese patients with coronary artery disease(CHD).Methods This study was conducted in a cohort of 403 patients with CHD receiving rosuvastatin therapy,among whom 341 patients had complete follow-up data concerning myalgia and 389 patients had documented measurements of plasma creatine kinase(CK)level.All these patients underwent genetic analysis using GSA chip for detecting mitochondria gene variants associated with myalgia.A logistic regression model was used to assess the association between 69 mitochondrial single-nucleotide polymorphisms(SNPs)and myopathy in 341 patients.The impact of these mutation sites on CK levels in 389 patients was evaluated by linear regression analysis.Results G12630A variant was identified to correlate with an increased risk of myalgia in CHD patients(OR:8.689,95%CI:1.586-47.6;P=0.01273),but CK levels did not differ significantly between patients with different genotypes of G12630A(P>0.05).SNPs at T12285C and A13105G were found to significantly correlate with CK levels in these patients(P<0.05).Conclusion Mitochondrial G12630A variation is associated with statin-induced myalgia in patients with CHD,indicating the necessity of different treatment strategies for patients who carry this risk allele.