上海某社区老年男性高血压病病人ApoE基因型与中医证型及血脂的相关性分析

The Correlation between ApoE Genotype and Traditional Chinese Medicine Syndrome and Blood Lipid in Elderly Male Hypertensive Patients in Shanghai Community

目的分析载脂蛋白E(apolipoprotein E,ApoE)基因型与老年男性高血压病病人中医证型及血脂的相关性,探索高血压病病人中医证型与血脂表型的遗传基础,为临床辨治高血压病提供新的思路。方法收集上海某社区体检老年男性高血压病病人284例,应用二代测序技术检测ApoE基因突变,分析老年男性高血压病病人的ApoE基因型与中医证型及血脂之间的相关性。结果4种中医证型病人年龄、吸烟、体质指数(BMI)、血脂比较差异无统计学意义(P>0.05);ApoE基因测序共检测出22个突变位点,均符合Hardy-Weinberg平衡(P>0.05)。其中rs769449、rs429358、rs7412突变率分别为13.38%、14.79%、13.03%。rs769449、rs429358、rs7412基因型在4种中医证型间的分布比较差异无统计学意义(P>0.05)。在肝火亢盛证中,rs7412 CC型、CT+TT型在三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)比较差异有统计学意义(P<0.05),在阴虚阳亢证中,rs769449 GG型、CA+AA型基因型在TC、LDL-C和HDL-C水平比较差异具有统计学意义(P<0.05);rs429358 TT型、TC+CC型在HDL-C比较差异具有统计学意义(P<0.05)。在痰瘀互结证中,rs429358 TT型、TC+CC型基因型在TC、LDL-C的水平比较差异有统计学意义(P<0.05)。结论老年男性高血压病病人中,rs7412 CC型是肝火亢盛证血脂异常的保护因素,rs769449 GG型是阴虚阳亢证血脂异常的保护因素,rs429358 TT型是阴虚阳亢证及痰瘀互结证血脂异常的危险因素。

Objective To analyze the correlation between apolipoprotein E(ApoE)genotype and traditional Chinese medicine(TCM)syndrome and blood lipid in elderly male hypertensive patients in Shanghai community,exploring the genetic basis of TCM syndromes and lipid phenotypes in hypertensive patients and providing a new way for clinical differentiation and treatment of hypertension.Methods Two hundred and eighty-four elderly hypertensive patients were collected.ApoE gene mutation was examined by second-generation sequencing.The correlation between ApoE genotype,TCM syndromes and blood lipid in elderly male hypertensive patients was analyzed.Results There was no significant difference in age,smoking history,body mass index(BMI)and blood lipid between TCM syndromes(P>0.05).A total of 22 mutation sites were detected by ApoE gene sequencing,which were in accordance with Hardy-Weinberg equilibrium(P>0.05).The mutation rates of rs769449,rs429358 and rs7412 were 13.38%,14.79%and 13.03%.There was no significant difference in the distribution of rs769449,rs429358 and rs7412 genotypes among the four TCM syndromes(P>0.05).In the hyperactivity of liver-fire syndrome,the difference of rs7412 CC and CT+TT in triglyceride(TG),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C)was significant(P<0.05).In Yin deficiency and Yang hyperactivity Syndrome,the difference of rs769449 genotype in TC,LDL-C and HDL-C were statistical significance(P<0.05).The difference of rs429358 TT and TC+CC in HDL-C was statistically significant(P<0.05).In the syndrome of phlegm and blood stasis,the difference of rs429358 genotype in TC and LDL-C was significant(P<0.05).Conclusion rs7412 CC type in elderly male hypertensive patients was a protective factor for dyslipidemia in the hyperactivity of liver-fire syndrome,rs769449 GG type was the protective factor of dyslipidemia in Yin deficiency and Yang hyperactivity syndrome,and rs429358 TT type was a risk factor of dyslipidemia in Yin deficiency and Yang hyperactivity syndrome and phlegm and blood stasis syndrome.