ApoE基因多态性对阿利西尤单抗调脂疗效影响的分析

Analysis of the effect of ApoE gene polymorphism on the lipid-regulating effect of aliciumab

目的探讨载脂蛋白E(ApoE)基因多态性对阿利西尤单抗调脂疗效的影响。方法回顾性选择187例血脂异常患者为研究对象。所有患者均接受阿利西尤单抗治疗6个月。通过Sequenom MassArray系统基因分型测定患者ApoE基因多态性,以基因型不同将患者分成风险类基因型E4组(42例)、大众类基因型E3组(123例)和保护类基因型E2组(22例)。对比3组患者治疗前后血脂水平及不良事件发生情况。结果187例患者中ε2、ε3、ε4等位基因频数占比分别为7.49%、78.88%、13.64%,基因型分布符合H-W平衡。治疗后,E2、E3、E4组的三酰甘油(TG)分别为(1.42±0.22)、(1.56±0.29)和(1.78±0.37)mmol·L^(-1),低密度脂蛋白胆固醇(LDL-C)分别为(1.85±0.19)、(2.02±0.25)和(2.23±0.41)mmol·L^(-1),载脂蛋白A1(APOA1)分别为(0.85±0.11)、(0.92±0.16)和(1.78±0.37)g·L^(-1),总胆固醇(TC)分别为(3.03±0.32)、(3.42±0.39)和(3.68±0.45)mmol·L^(-1),高密度脂蛋白胆固醇(HDL-C)分别为(1.41±0.32)、(1.33±0.26)和(1.19±0.20)mmol·L^(-1),差异均有统计学意义(均P<0.05)。E2、E3、E4组的不良事件总发生率分别为9.09%、11.38%、19.05%,在统计学上差异均无统计学意义(均P>0.05)。结论相比于E3、E4亚型,E2亚型具有更优的调脂效果,但不同亚型不会影响患者的用药安全性。

Objective To investigate the impact of apolipoprotein E(ApoE)gene polymorphism on the lipid-modifying efficacy of alirocumab.Methods A total of 187 patients with dyslipidemia were retrospectively selected for this study.All patients received alirocumab therapy for 6 months.The patients'ApoE gene polymorphism was determined by genotyping using the Sequenom MassArray system,and they were divided into risk type genotype E4 group(42 cases),common type genotype E3 group(123 cases),and protective type genotype E2group(22 cases)based on different genotypes.The lipid levels and occurrence of adverse events before and after treatment were compared among the three groups.Results Among the 187 patients,the allele frequencies ofε2,ε3 andε4 were 7.49%,78.88%and 13.64%,respectively,and the genotype distribution was in Hardy-Weinberg equilibrium.After treatment,the triglycerides(TG)levels in the E2,E3 and E4 groups were(1.42±0.22),(1.56±0.29)and(1.78±0.37)mmol·L^(-1),respectively;low-density lipoprotein cholesterol(LDL-C)levels were(1.85±0.19),(2.02±0.25)and(2.23±0.41)mmol·L^(-1),respectively;apolipoprotein A1(ApoA1)levels were(0.85±0.11),(0.92±0.16)and(1.78±0.37)g·L^(-1),respectively;total cholesterol(TC)levels were(3.03±0.32),(3.42±0.39)and(3.68±0.45)mmol·L^(-1),respectively;high-density lipoprotein cholesterol(HDL-C)levels were(1.41±0.32),(1.33±0.26)and(1.19±0.20)mmol·L^(-1),respectively,with statistically significant differences(all P<0.05).The overall incidence of adverse events in the E2,E3 and E4 groups were 9.09%,11.38%and 19.05%,respectively,with no statistically significant difference(all P>0.05).Conclusion Compared to the E3 and E4 subtypes,the E2 subtype has superior lipid-modifying effects,but different subtypes do not affect the safety of drug use in patients.