Ⅰ型血小板结合蛋白基序的解聚蛋白样金属蛋白酶1基因多态性与老年原发性高血压患者颈动脉粥样硬化斑块形成的关系

The relationship between a disintegrin and metalloproteinase with thrombospondin motifs 1 gene polymorphism and carotid atherosclerotic plaque formation in elderly patients with essential hypertension

目的分析Ⅰ型血小板结合蛋白基序的解聚蛋白样金属蛋白酶1(ADAMTS-1)基因多态性与老年原发性高血压(EH)患者颈动脉粥样硬化斑块(CAP)形成的关系。方法选择2015年1月至2021年7月于河北医科大学第一医院门诊或住院治疗的老年EH患者400例为研究对象。根据患者是否有CAP形成,将患者分为非斑块组(144例)和斑块组(256例)。比较2组ADAMTS-1基因rs402007位点等位基因和基因型频率。采用Logistic回归方法分析老年EH患者CAP形成的影响因素,建立列线图模型,采用受试者工作特征(ROC)曲线评估列线图模型对老年EH患者CAP形成的预测能力。结果斑块组ADAMTS-1基因rs402007位点C等位基因及CC基因型频率均高于非斑块组[46.3%(237/512)比36.8%(106/288)、21.5%(55/256)比13.9%(20/144)],差异均有统计学意义(均P<0.001)。多因素Logistic回归分析结果显示,收缩压、尿酸、高密度脂蛋白胆固醇、同型半胱氨酸、C反应蛋白、ADAMTS-1基因rs402007位点CC+CG基因型是老年EH患者CAP形成的独立相关因素(均P<0.05)。纳入所有独立相关因素建立的列线图模型的一致性指数为0.948(95%置信区间:0.925~0.983)。ROC曲线分析结果显示,该列线图模型预测老年EH患者CAP形成的曲线下面积为0.854(95%置信区间:0.826~0.892)。结论ADAMTS-1基因rs402007位点C等位基因是老年EH患者CAP形成的遗传易感等位基因。

Objective To analyze the relationship between a disintegrin and metalloproteinase with thrombospondin motifs 1(ADAMTS-1)gene polymorphism and carotid atherosclerotic plaque(CAP)formation in elderly patients with essential hypertension(EH).Methods From January 2015 to July 2021,400 elderly EH patients in the outpatient or inpatient of the First Hospital of Hebei Medical University were selected.Depending on whether patients had CAP,they were divided into non plaque group(144 cases)and plaque group(256 cases).The allele and genotype frequencies of rs402007 locus of ADAMTS-1 gene in the two groups were compared.The influencing factors of CAP formation in elderly EH patients were analyzed by Logistic regression method,the nomogram model was established,and the receiver operating characteristic(ROC)curve was used to evaluate the predictive ability of nomogram model on CAP formation in elderly EH patients.Results The frequencies of C allele and CC genotype at rs402007 locus of ADAMTS-1 gene in plaque group were higher than those in non plaque group[46.3%(237/512)vs 36.8%(106/288),21.5%(55/256)vs 13.9%(20/144)](both P<0.001).Multivariate Logistic regression analysis showed that systolic blood pressure,uric acid,high-density lipoprotein cholesterol,homocysteine,C-reactive protein and CC+CG genotype at rs402007 locus of ADAMTS-1 gene were independent related factors for CAP formation in elderly EH patients(all P<0.05).The consistency index of the nomogram model including all independent related factors was 0.948(95%confidence interval:0.925-0.983).ROC curve analysis showed that the area under the curve of the nomogram model for CAP formation in elderly EH patients was 0.854(95%confidence interval:0.826-0.892).Conclusion The C allele at rs402007 locus of ADAMTS-1 gene is a genetic susceptibility allele for CAP formation in elderly patients with EH.