APOE基因多态性与血脂异常相关性分析

Apolipoprotein E Gene Polymorphism and Its Effect on Plasma Lipids

目的:了解不同APOE基因型人群与血脂紊乱的相关性,指导合理治疗。方法:收集2015年11月至2016年4月我院高脂血症患者62例[高胆固醇(TC)、高甘油三酯(TG)、高低密度脂蛋白(LDL-C)任其一者]行APOE基因表型检测,根据不同的基因表型分为3组:E2表型组(E2/E2,E2/E3)、E3表型组(E3/E3,E2/E4)、E4表型组(E3/E4,E4/E4),对其结果与脂代谢紊乱相关性进行统计分析,选择性治疗。结果:62例高脂血症患者,其中高TC 21例;高TG 31例;高LDL-C 22例。APOE基因表型组各占比分别为E2型16.13%,E3型64.52%,E4型19.35%。血脂异常类型与APOE基因表型分布:TC异常类型中E4表型组占比最多,为50%;E2表型组占比最少,为10%;TG异常类型中E2表型组占比最多,为70%;E4表型组占比最少,为41.6%。LDL-C异常类型中E4表型组占比最多,为50%;E2表型组占比最少,为20%。3组基因表型TG、LDL-C浓度水平无统计学差异(P>0.05),E2、E3表型组TC浓度水平与E4表型组比较存在统计学差异(P<0.05)。3组均值比较显示E2表型组TG浓度最高,E4表型组TC、LDL-C浓度均值最高。结论:高脂血症是冠心病常见的危险因素,APOE不同的基因表型间个体血脂水平存在差异,临床上可根据APOE不同的基因表型指导患者正确选择调脂药物和饮食干预治疗,以期降低冠心病的发病率和心血管事件风险。

Objective:To evaluate the effect of apolipoprotein E polymorphism on blood lipid and response to treatment in patients with different types of dyslipidemia.Methods:From November2015 to April 2016,a total of 62 subjects who were diagnosed with different types of dyslipidemia-high total cholesterol(TC),high triglyceride(TG),high low density lipoprotein cholesterol(LDL-c)in Zhongnan Hospital of Wuhan University were recruited into this study.Genotypes of apo E isoforms(E2,E3,and E4)for all above subjects were detected and subjects were divided into three groups according to their Genotypes-E2(E2/E2,E2/E3),E3(E3/E3,E2/E4),and E4(E3/E4,E4/E4).In addition,plasma samples were also detected to analyze TC,TG and LDL-c levels.Results:Among all these subjects,there were 21 cases of high TC,31 of high TG,22 of high LDL-C.The occurrence frequency of each genotype in the study was E2 16.13%,E364.52%,and E4 19.35%.There were no statistical significance among the groups on TG and LDL-C levels(P>0.05).E4 group had statistical significance on TC levels as compared with E2 and E3(P<0.05).Moreover,their mean values of blood lipid were also compared.E2 had largest mean value of TG level among these groups,and E4 had largest mean value both on LDL-C and TC levels.Conclusion:Variability of Apo-E gene locus may be associated with the plasma lipid levels and important risk factors for arterial disease,which might be used to guide the patients who have different phenotypes to take rational drugs,restrict diet and monitor adverse drug reactions.