三酰甘油与APOE基因多态性在短暂性脑缺血发作患者发生急性脑梗死中的交互作用研究

Interaction of Triglyceride and APOE Gene Polymorphisms in the Occurrence of Acute Cerebral Infarction in Patients with Transient Ischemic Attack

目的探讨三酰甘油(TG)与载脂蛋白E(APOE)基因多态性在短暂性脑缺血发作(TIA)患者发生急性脑梗死中的交互作用。方法对2019年1月—2021年6月349例TIA进行6个月随访,根据是否发生急性脑梗死分为发生组、未发生组,比较2组一般资料、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、TG、APOE基因多态性,并比较不同TG水平患者APOE基因多态性,使用多因素Logistic回归分析TIA发生急性脑梗死的影响因素,使用交互作用系数γ分析TG与APOE基因多态性的交互作用。结果随访6个月,共45例(12.89%)TIA患者发生急性脑梗死。发生组TG高于未发生组(P<0.01)。发生组及TG升高患者E3/3基因型、ε3等位基因频率分别低于未发生组及TG正常患者,E3/4基因型、ε4等位基因频率分别高于未发生组及TG正常患者(P<0.05)。校正TIA持续时间、TIA发作频率后,TG、APOE基因型E3/3、E3/4及等位基因ε4仍是TIA发生急性脑梗死的独立影响因素(P<0.01)。TG升高与APOE基因型E3/4在TIA发生急性脑梗死中呈正向交互作用,且交互作用符合次相乘模型。结论TG升高与APOE基因型E3/4在TIA发生急性脑梗死中呈正向交互作用,且交互作用符合次相乘模型,TG升高可增强APOE基因型E3/4对TIA发生急性脑梗死的易感性。

Objective To investigate the interaction between triacylglycerol(TG)and apolipoprotein E(APOE)gene polymorphisms in the occurrence of acute cerebral infarction(ACI)in patients with transient ischemic attack(TIA).Methods A total of 349 patients TIA from January 2019 to June 2021 were followed up for 6 months.They were divided into occurrence group and non-occurrence group according to presence of ACI.The general data,total cholesterol(TC),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C),TG and APOE gene polymorphism of the two groups were compared.Furthermore,APOE gene polymorphism in patients with different TG levels was compared,and the influencing factors of TIA complicated with ACI were analyzed by multivariate Logistic regression analysis.Interaction coefficientγwas used to analyze the interaction between TG and APOE gene polymorphism and the type of interaction.Results At 6 months after follow-up,a total of 45(12.89%)TIA patients experienced ACI.The TG of occurrence group was higher than that of non-occurrence group(P<0.01).The frequency of E3/3 genotype andε3 allele in occurrence group and patients with increased TG were lower than those in non-occurrence group and patients without noraml TG,respectively,while the frequency of E3/4 genotype andε4 allele were higher than those in non-occurrence group and patients with normal TG respectively(P<0.05).After adjusting for the duration and frequency of TIA,TG,APOE genotype E3/3,E3/4 andε4 alleles were still the independent influencing factors of TIA complicated with ACI(P<0.01).The increase of TG and APOE genotype E3/4 had a positive interaction in TIA complicated with ACI,and the interaction was consistent with the submultiplicative model.Conclusion The increase of TG positively interacts with APOE genotype E3/4 in TIA complicated with ACI,and the interaction is consistent with the submultiplicative model.The increase of TG can enhance the susceptibility of APOE genotype E3/4 to TIA complicated with ACI.