【作者】 何广彦；

【导师】 张七一；

【作者基本信息】 泰山医学院 ， 内科学， 2009， 硕士

【摘要】 目的研究载脂蛋白A5基因(APOA5)-1131T/C多态性在正常健康人群和老年高血压患者中的基因频率和等位基因频率分布情况,探讨-1131T/C多态性对血浆脂质代谢、动脉弹性的影响及其与老年高血压风险性之间的关系,了解其在老年高血压发生过程中的作用,并探讨其在老年高血压发生中的机制。方法采用聚合酶链反应-限制性片段长度多态性(PCR-RFLP)结合琼脂糖凝胶电泳技术(AGE),对随机选择的非亲属青岛地区汉族老年高血压患者130例(平均年龄71.24±5.72岁),以及年龄和性别相匹配的健康体检者120例为对照组(平均年龄70.49±6.43岁),检测了APOA5基因-1131T/C多态性基因型和等位基因的分布;同时采用生化方法检测了研究对象的血脂水平;应用彩色多普勒超声诊断仪测定右颈总动脉内膜中层厚度(IMT)、收缩末期内径(Ds)、舒张末期内径(Dd),计算压力应变弹性系数(EP)、僵硬系数(β)、动脉顺应性(AC)。结果老年高血压组和对照组两组人群中APOA5基因-1131T/C多态性基因型频率存在明显差异(P=0.014),老年高血压组APOA5 -1131C等位基因频率明显高于对照组(0.419比0.296,P= 0.004)。C基因携带者(TC+CC基因型)患高血压的风险是TT基因型的2.03倍(95%CI:1.21～3.39),经校正年龄、性别、体重指数、吸烟史、饮酒、高血压家族史及血清HDL-C、LDL-C水平等相关影响因素,其差异仍具有统计学意义(OR=1.65 95%CI:1.04～2.61);老年高血压组APOA5基因-1131T/C多态性不同基因型亚组间的TG水平差异有统计学意义(P<0.01),CC、TC组明显高于TT组,而CC组的TG水平最高;其他血脂指标差异无统计学意义(P>0.05);老年高血压组的EP、β、IMT均明显高于对照组,而AC明显低于对照组(P<0.01),无论老年高血压组还是对照组中,三种基因型的EP、β、AC、IMT差异均无统计学意义(P>0.05)。结论本研究证实APOA5基因可能是高血压的候选基因;APOA5基因-1131位点T/C多态性为老年高血压的遗传标记,-1131C等位基因可能与老年高血压的发生相关联, APOA5基因-1131T/C多态性对人群血清TG水平有重要影响,与EP、β、AC、IMT无明显关联。更多还原

【Abstract】 ObjectiveTo investigate the distribution of apolipoprotein A5 (APOA5) gene -1131T/C polymorphism in the Han population in Qingdao, and to explore its effects on lipid metabolism and artery elasticity, and the association between susceptibility to elderly hypertension and the -1131T/C polymorphism in the APOA5 gene.MethodsUsing polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and agarose gelelectrophoresis (AGE) methods, we analyzed the genotypes and alleles in 130 elderly patients with essential hypertension (mean age 71.24±5.72years) and 120 healthy controls (mean age 70.49±6.43 years).The levels of serum lipid profiles were studied by biochemicalmethods. Using color doppler ultrasound we measured systolic inner diameter (Ds), diastolic inner diameter (Dd) and intima-media thickness (IMT) of the right common carotid artery (RCCA) and calculated pressure-strain elastic modulus (Ep), stiffness (β) and the arterial compliance (AC). ResultsThe frequency of APOA5 -1131TT, TC, CC genotypes were distinctlydifferent between groups of elderly patients with essential hypertension andcontrol (P=0.014). The frequency of the APOA5 -1131 C allele in elderly hypertensive patients was significantly higher than that of the controlgroup (0.419 vs 0.296 P=0.004).Compared with the wild type TT, TC heterozygote+CC homozygote had a significantly increased elderly hypertensionrisk (OR =2.03 and OR=1.65 using unadjusted and adjusted logistic regression models,respectively).This association still existed after adjustment for the sex, age, BMI, smoking, alcohol, hypertensive familial history and the levels of serumHDL-C and LDL-C.APOA5 -1131TT, TC, CC genotypes al-so showed a co-rrelation with plasma TG levels in elderly hypertensive pat-ients (P<0.01).The -1131C allele contributed to the increase of serum levels of TG but had no effect on profiles of TC, HDL-C, LDL-C in elderlyhypertensive pa-tients.In the elderly hypertensive group, the serumlevels of TG of CC ge-notype were significantly higher than those of TT genotype and TC genot-ype.The serum levels of TG of TC genotype was higher than that of TT genotype.Compared with the normal group,data of Ep,βweresignificantly hi-gher in hypertension group(P<0.01),while AC was obviouslylower(P<0.01). However, there was no significance in profiles of IMT, Ep,βand AC in va-rious genotypes in both groups.ConclusionsThe APOA5 -1131T/C polymorphism might contribute to an increased risk of elderly hypertension among Chinese accompanied by an elevation of serum TG levels. The APOA5 -1131T/C polymorphism was not related with artery elasticity.更多还原