TLR4基因多态性及幽门螺杆菌感染与冠心病易感性的关联

Association between TLR4 gene polymorphisms, Helicobacter pylori infection and susceptibility to coronary heart diseases

目的探究Toll样受体4(TLR4)基因多态性及幽门螺杆菌(Hp)感染与冠心病(CHD)易感性的关联。方法选取2016年6月-2021年6月运城市中心医院收治200例CHD患者为CHD组,另选取200名健康体检者为对照组,采用聚合酶链式反应-限制性片段长度多态性技术(PCR-RFLP)分析TLR4 rs10759932多态性位点基因型,采用14C呼气试验检测Hp感染,采用冠脉造影Gensini积分法判定冠脉病变严重程度。结果CHD组患者TLR4 rs10759932位点TT基因型频率63.50%、T等位基因频率78.75%,高于对照组的52.50%、69.75%(P<0.05);CHD组患者Hp感染阳性率68.00%,高于对照组的56.00%(P<0.05)。调整性别、年龄、体质量指数、文化程度、吸烟史、饮酒史后,TLR4 rs10759932位点基因型(TT+TC)型CHD风险是CC型的2.175倍(95%CI:1.126~4.202),Hp感染阳性者CHD风险是Hp感染阴性者的1.586倍(95%CI:1.067~2.356)。TLR4 rs10759932位点(TT+TC)型CHD患者血清低密度脂蛋白胆固醇(LDL-C)、超敏C-反应蛋白(hs-CRP)、同型半胱氨酸(Hcy)水平及Gensini评分均高于CC型(P<0.05),且Hp感染阳性组患者血清LDL-C、hs-CRP、Hcy水平及Gensini评分均高于阴性组(P<0.05)。结论TLR4 rs10759932位点T等位基因携带、Hp感染均是CHD易感因素,且与患者血脂异常、炎症反应及病情严重程度存在相关性。

OBJECTIVE To explore the association between Toll-like receptor 4(TLR4) gene polymorphism, Helicobacter pylori(Hp) infection and susceptibility to coronary heart disease(CHD). METHODS A total of 200 patients with CHD who were treated in Yuncheng Central Hospital from Jun 2016 to Jun 2021 were assigned as the CHD group, and 200 healthy people who received physical examination were chosen as the control group. The genotypes at TLR4 rs10759932 polymorphism locus were analyzed by polymerase-chain-reaction-restriction-fragment-length polymorphism(PCR-RFLP) assay, the Hp infection was tested byC breath testing, and the severity of coronary artery lesions was determined by Gensini score of coronary angiography. RESULTS The frequency of TT genotype at TLR4 rs10759932 locus of the CHD group was 63.50%, significantly higher than 52.50% of the control group;the frequency of T allele of the CHD group was 78.75%, significantly higher than 69.75% of the control group(P<0.05). The positive rate of Hp infection of the CHD group was 8.00%, significantly higher than 56.00% of the control group(P<0.05). After the gender, age, body mass index, education level, smoking history and alcohol drinking history were adjusted, the patients with genotype(TT+TC) at TLR4 rs10759932 locus were 2.175 times the risk of CHD as high as the patients with genotype CC(95%CI:1.126-4.202), the patients with positive Hp infection were 1.586 times the risk of CHD as high as the patients with negative Hp infection(95%CI:1.067-2.356). The levels of serum low-density lipoprotein cholesterol(LDL-C), high-sensitivity C-reactive protein(hs-CRP) and homocysteine(Hcy) as well as Gensini score of the patients with(TT+TC) genotype at TLR4 rs10759932 locus were significantly higher than those of the patients with CC genotype(P<0.05);the levels of serum LDL-C, hs-CRP and Hcy as well as Gensini score of the patients with positive Hp infection were significantly higher than those of the patients with negative Hp infection(P<0.05). CONCLUSION The T allele at TLR4 rs10759932 locus and Hp infection are the susceptible factors for CHD and are associated with the dyslipidemia, inflammatory reaction and severity of disease.