白细胞介素-1家族基因型与老年人冠心病相关性分析

摘要

目的 探讨白细胞介素-1(IL-1)家族(IL-1α、IL-1β)和白细胞介素-1受体拮抗剂(IL-1Ra)基因型与老年人冠心病风险及血脂水平的相关性. 方法 应用聚合酶链反应和限制性片段长度多态性的方法检测了329例老年冠心病患者和318例老年对照者IL-1家族基因型,同时检测了血脂水平. 结果 老年冠心病组IL-1Ra“TT”和IL-1Ra“Ⅰ/Ⅰ与Ⅰ/Ⅳ”基因型频率为90.3％,而对照组基因型频率均为82.4％,与对照组比较,IL-1Ra“TT、Ⅰ/Ⅰ或Ⅰ/Ⅳ”基因型携带者,其患老年冠心病的风险是IL-1Ra“CC或TC”和IL-1Ra“Ⅰ/Ⅱ或Ⅱ/Ⅱ”基因型的1.98倍(x2=8.55,95％CI:1.25～3.16);在老年冠心病人群中,急性冠状动脉综合征组IL-1Ra“TT”和IL-1Ra“Ⅰ/Ⅰ与Ⅰ/Ⅳ”基因型频率为96.2％,而稳定型心绞痛组基因型频率均为84.8％,与稳定型心绞痛组比较,其患急性冠状动脉综合征的风险为4.54倍(x2=12.17,95％CI:1.81～11.36);急性冠状动脉综合征组IL-1α-889“CT或TT”基因型频率为22.8％,而稳定型心绞痛组基因型频率为7.6％,IL-1(-889)“CT或TT”基因型携带者,其患急性冠状动脉综合征的风险约是IL-1α (-889)“CC”基因型的3.59倍(x2=14.93,95％CI:1.82～7.03);各组基因型间血脂水平的比较差异无统计学意义(P＞0.05). 结论 在老年冠心病人群中,IL-1α (-889)“CT或TT”基因型携带者患急性冠状动脉综合征的风险较高,而IL-1Ra“CC、TC、Ⅰ/Ⅱ或Ⅱ/Ⅱ”基因型携带者患老年冠心病或患严重老年冠心病的风险较低.%Objective To investigate the correlation of interleukin-1 family genotypes,including interleukin-1 (IL-1α,IL-1β) and interleukin-1 receptor antagonist (IL-1Ra),with coronary heart disease (CHD) and serum lipoprotein level in the elderly.Methods Interleukin-1 family genotypes were detected in 318 elderly controls and 329 elderly CHD patients by polymerase chain reaction and restriction fragment length polymorphisms method.Serum levels of lipoproteins were inspected simultaneously.Results The TT and Ⅰ / Ⅰ or Ⅰ/Ⅳ genotype frequency of IL-1Ra was 90.3％ in elderly CHD patients,but 82.4％ in controls.Carriers with TT,Ⅰ / Ⅰ or Ⅰ/Ⅳ genotype of IL-1Ra were at an increased risk with an odds ratio of 1.98 in elderly CHD patients as compared with controls (x2=8.55,95％ CI:1.25-3.16).The TT and Ⅰ/Ⅰ or Ⅰ/Ⅳ genotype frequency of IL-1Ra was 96.2％ in elderly CHD patients with acute coronary syndrome,but 84.8％ in elderly CHD patients with stable angina.Carriers with TT,Ⅰ / Ⅰ or Ⅰ/Ⅳ genotype of IL-1Ra were at an increased risk with an odds ratio of 4.54 in acute coronary syndrome group as compared with stable angina group (x2=12.17,95％CI:1.81-11.36).The CT or TT genotype frequency of IL-1α-889 was 22.8％ in acute coronary syndrome group,but 7.6 ％ in stable angina group.Carriers with CT or TT genotype of IL-1α-889 were at an increased risk with an odds ratio of 3.59 as compared with stable angina group (x2 =14.93,95％CI:1.82-7.03).There were no significant differences in levels of serum lipoproteins among the different genotypes (P＞0.05).Conclusions In elderly patients with coronary heart disease,IL-1α(-889) CT or TT genotype carriers are at high risk for acute coronary syndrome,but IL-1Ra CC,TC,Ⅰ / Ⅱ or Ⅱ / Ⅱ genotype carriers are at a low risk for CHD or severe CHD.