急性心肌梗死老年患者NLRP3基因多态性与炎症指标的关联性

Association between NLRP3 gene polymorphisms and inflammatory marks in elderly patients with acute myocardial infarction

目的探究急性心肌梗死老年患者NLRP3基因多态性与炎症指标的关联性。方法选择2019年1月至2021年1月于蚌埠医学院第二附属医院就诊的急性心肌梗死老年患者126例作为研究组,选择同期体检的健康者100例作为对照组。抽取所有研究对象的空腹静脉血,检测血清高敏C反应蛋白(hs-CRP)、白介素1β(IL-1β)、白介素18(IL-18)以及NLRP3水平,比较研究组和对照组的差异。检测研究组患者NLPR3基因rs10754558位点、rs35829419位点的多态性,比较不同基因型患者血清hs-CRP、IL-1β、IL-18水平的差异。结果研究组患者hs-CRP、IL-1β、IL-18、NLRP3水平均显著高于对照组[(4.8±2.3)mg/dl vs(1.4±0.9)mg/dl,P<0.001;(186.4±18.3)ng/ml vs(46.3±16.7)ng/ml,P<0.001;(241.6±32.5)pg/ml vs(124.6±28.1)pg/ml,P<0.001;(1.94±0.65)pg/ml vs(0.92±0.54)pg/ml,P<0.001],肌钙蛋白阳性比例显著高于对照组(72.22%vs 0,P<0.001)。研究组中,rs10754558位点GG基因型血清hs-CRP[(5.6±2.4)mg/L]、IL-1β[(217.6±16.7)ng/ml]、IL-18[(264.3±24.7)pg/ml]水平最高,GC基因型次之[(4.6±2.1)mg/L、(177.1±16.3)ng/ml、(236.8±24.1)pg/ml],CC基因型最低[(4.0±2.1)mg/L、(156.4±15.9)ng/ml、(210.2±23.9)pg/ml],组间差异均具有统计学意义(P<0.05)。rs35829419位点AA基因型hs-CRP[(7.0±1.9)mg/L]、IL-1β[(229.2±17.2)ng/ml]、IL-18[(285.3±28.6)pg/ml]水平最高,AC基因型次之[(5.3±2.0)mg/L、(194.3±16.8)ng/ml、(253.4±28.9)pg/ml],CC基因型最低[(4.6±1.8)mg/L、(183.0±17.0)ng/ml、(236.3±28.2)pg/ml],组间差异均具有统计学意义(P<0.05)。GG+GC(OR=1.726,95%CI:1.306~4.018,P<0.001)、AA+AC(OR=4.617,95%CI:2.512~8.019,P<0.001)是影响急性心肌梗死的独立危险因素。结论急性心肌梗死老年患者NLRP3基因rs10754558位点、rs35829419位点基因多态性影响血清炎症指标水平。

Objective To investigate the association between NLRP3 gene polymorphisms and inflammatory marks in elderly patients with acute myocardial infarction.Methods One hundred and twenty-six elderly patients with acute myocardial infarction at the Second Affiliated Hospital of Bengbu Medical College from January 2019 to December 2021 were selected as a study group,and 100 healthy people were selected as a control group.Fasting venous blood was collected from all subjects to detect serum high-sensitivity C-reactive protein(hs-CRP),interleukin-1β(IL-1β),interleukin-18(IL-18),and NLRP3 levels,and the differences between the study group and control group were compared.The polymorphisms of the NLPR3 gene(rs10754558 and rs35829419)were detected in the study group,and the differences in serum hs-CRP,IL-1β,and IL-18 levels in patients with different genotypes were compared.Results The levels of hs-CRP,IL-1β,IL-18,and NLRP3 in the study group were significantly higher than those in the control group[(4.8±2.3)mg/dl vs(1.4±0.9)mg/dl,P<0.001;(186.4±18.3)ng/ml vs(46.3±16.7)ng/ml,P<0.001;(241.6±32.5)pg/ml vs(124.6±28.1)pg/ml,P<0.001;(1.94±0.65)pg/ml vs(0.92±0.54)pg/ml,P<0.001],and the positive rate of troponin was significantly higher than that of the control group(72.22%vs 0,P<0.001).In the study group,the GG genotype of rs10754558 was associated with the highest levels of serum hs-CRP[(5.6±2.4)mg/L],IL-1β[(217.6±16.7)ng/ml],and IL-18[(264.3±24.7)pg/ml],followed by the GC genotype[(4.6±2.1)mg/L,(177.1±16.3)ng/ml,and(236.8±24.1)pg/ml,respectively]and the CC genotype[(4.0±2.1)mg/L,(156.4±15.9)ng/ml,and(210.2±23.9)pg/ml,respectively];the differences between any two of them were statistically significant(P<0.05).The AA genotype of rs35829419 was associated with the highest levels of hs-CRP[(7.0±1.9)mg/L],IL-1β[(229.2±17.2)ng/ml],and IL-18[(285.3±28.6)pg/ml],followed by the AC genotype[(5.3±2.0)mg/L,(194.3±16.8)ng/ml,and(253.4±28.9)pg/ml,respectively]and the CC genotype[(4.6±1.8)mg/L,(183.0±17.0)ng/ml,and(236.3±28.2)pg/ml,respectively];the differences between any two of them were statistically significant(P<0.05).The GG+GC[odds ratio[OR]=1.726,95%CI 1.306-4.018,P<0.001]and AA+AC[OR=4.617,95%CI 2.512-8.019,P<0.001]genotypes were independent risk factors for acute myocardial infarction.Conclusion The NLRP3 gene polymorphisms rs10754558 and rs35829419 affect serum inflammatory marks levels in elderly patients with acute myocardial infarction.