载脂蛋白C1基因多态性与缺血性中风痰瘀证血脂代谢相关性研究

Study on the Relationship Between the Gene Polymorphism of Apolipoprotein C1 and Lipid Metabolism in Ischemic Stroke with Phlegm and Blood Stasis Syndrome

目的:探讨载脂蛋白C1(apolipoprotein C1,APOC1)基因多态性与缺血性中风易感性及临床指标的相关性。方法:选择广西中医药大学第一附属医院脑病二科533例缺血性脑卒中患者为病例组,并选择同时期该院体检中心健康体检者或骨科及其他病势较轻的外伤患者531例为对照组。应用Sequenom技术对APOC1基因rs4420638位点进行基因分型。应用PLINK软件进行遗传关联分析。结果:两组受试者rs4420683的基因型频率比较,差异具有统计学意义(χ^(2)=8.725 P=0.013);在显性模型、隐形模型、加性模型中,APOC1基因rs4420683多态性与缺血性中风痰瘀证发生风险的关联比较,差异无统计学意义(P>0.05);经年龄、性别校正后,关联仍无统计学意义(P_(adj)>0.05);按性别分层分析,在男性、女性受试者中,APOC1基因的多态性与缺血性中风痰瘀证发生风险的关联均无统计学意义(P>0.05);校正年龄后,关联仍无统计学意义(P_(adj)>0.05)。在校正性别、年龄后结果显示,APOC1基因多态性与缺血性中风痰瘀证患者收缩压、舒张压水平的相关性比较,差异均无统计学意义(P_(adj)>0.05);APOC1基因rs4420683多态性与缺血性中风痰瘀证患者空腹血糖及餐后2 h血糖的相关性比较,差异均无统计学意义(P_(adj)>0.05);APOC1基因多态性与缺血性中风痰瘀证患者的高密度脂蛋白(high density lipoprotein,HDL)[显性模型:β=0.09,95%CI(0.02,0.16),P=0.010)]、低密度脂蛋白(low density lipoprotein,LDL)[显性模型:β=0.25,95%CI(0.03,0.46),P=0.025)]显著相关;rs4420683多态性与缺血性中风痰瘀证患者HDL[显性模型:β_(adj)=0.08,95%CI adj(0.01,0.15),P_(adj)=0.021]、LDL[显性模型:β_(adj)=0.23,95%CI adj(0.01,0.44),P_(adj)=0.037]也具有相关性。结论:APOC1基因rs4420638的多态性可能会对缺血性中风痰瘀证的发生和发展产生影响,其作用机制可能涉及对血脂代谢的调节。

Objective:To investigate the relationship between gene polymorphisms of apolipoprotein C1(APOC1)and susceptibility to ischemic stroke and clinical indicators.Methods:The study selected 533 patients with ischemic stroke from the Department of Brain Diseases II of The First Affiliated Hospital of Guangxi University of Chinese Medicine into the case group,and selected 531 healthy individuals who had undergone physical examinations at the hospital's health examination center,or patients with less severe injuries from other departments or bone diseases into the control group.The APOC1 gene rs44206 polymorphism was genotyped using Sequenom technology.Genetic association analysis was conducted using PLINK software.Results:The results showed that there was a statistically significant difference in the genotype frequencies of rs4420683 between the two groups(χ^(2)=8.725,P=0.013).However,there was no statistically significant association between the APOC1 gene rs4420683 polymorphism and the risk of ischemic stroke with phlegm and blood stasis syndrome in the explicit model,the invisible model,and the additive model(P>0.05).After age and sex were adjusted,the association remained statistically insignificant(P_(adj)>0.05).After stratified analysis by gender,there was no statistically significant association between the APOC1 gene polymorphism and the risk of ischemic stroke with phlegm and blood stasis syndrome in either males or females(P>0.05);after age was adjusted,the association was still not statistically significant(P_(adj)>0.05).After gender and age were adjusted,and the results showed that there was no statistically significant association between the APOC1 gene polymorphism and blood pressure levels(systolic blood pressure and diastolic blood pressure)in ischemic stroke patients with phlegm and blood stasis syndrome(P_(adj)>0.05).The rs4420683 polymorphism of the APOC1 gene was not significantly associated with FPG and 2 hPBG levels in patients with ischemic stroke and phlegm-blood stasis syndrome(P_(adj)>0.05).The APOC1 gene polymorphism was significantly associated with the HDL level[the explicit model:β=0.09,95%CI(0.02,0.16),P=0.010)and the LDL level[the explicit model:β=0.25,95%CI(0.03,0.46),P=0.015)in patients with ischemic stroke with phlegm-blood stasis syndrome.The rs4420683 polymorphism was still statistically significant in association with HDL[the explicit model:β_(adj)=0.08,95%CI adj(0.01,0.15),P_(adj)=0.021)and LDL[the explicit model:β_(adj)=0.23,95%CI adj(0.01,0.44),P_(adj)=0.037)in patients with ischemic stroke with phlegm-blood stasis syndrome.Conclusion:The polymorphism of the APOC1 gene rs44206 may have an impact on the occurrence and development of ischemic stroke with phlegm and blood stasis syndrome,and its mechanism of action may involve regulation of lipid metabolism.