邯郸地区汉族人群酰基辅酶 A：胆固醇酰基转移酶1位点rs1044925基因多态性与冠心病患者血脂代谢的相关性研究

摘要

目的：探究酰基辅酶 A：胆固醇酰基转移酶1（ACAT-1）位点1044925基因多态性与冠心病患者血脂代谢的相关性。方法选取2015年邯郸市第一医院心内一科收治的冠心病住院患者396例作为冠心病组，另选择同期冠状动脉造影检查正常者428例作为对照组。采用聚合酶链反应-限制性片段长度多态性分析法（PCR - RFLP）对两组患者ACAT-1位点 rs1044925基因多态性进行分析。比较两组受试者体质指数（ BMI）、血脂指标、ACAT-1位点rs1044925基因型及等位基因分布情况，分别比较两组不同基因型受试者血脂指标。结果冠心病组患者 BMI 及血清三酰甘油（TG）、总胆固醇（TC）、低密度脂蛋白胆固醇（ LDL-C）、非高密度脂蛋白胆固醇（ nHDL-C）、脂蛋白（a）水平均高于对照组，血清高密度脂蛋白胆固醇（HDL-C）水平低于对照组（P <0.05）；两组受试者血清载脂蛋白 A1（ApoA1）、载脂蛋白 B（ApoB）水平比较，差异无统计学意义（P >0.05）。两组受试者基因型和 A、C 等位基因分布情况比较，差异均无统计学意义（ P >0.05）。对照组不同基因型受试者血清 TC、TG、LDL-C、nHDL-C、LDL-C、ApoA1、ApoB 及脂蛋白（a）水平比较，差异均无统计学意义（ P >0.05）。冠心病组不同基因型患者血清 TC、TG、nHDL-C、ApoA1、ApoB 及脂蛋白（a）水平比较，差异均无统计学意义（P >0.05）；AA 基因型患者血清HDL-C水平低于 AC/ CC 基因型患者，血清LDL-C水平高于 AC/ CC 基因型患者（P <0.05）；采用协方差分析校正性别、年龄和BMI，结果显示冠心病组 AA 基因型患者血清HDL-C水平低于 AC/ CC 基因型患者，血清LDL-C水平高于 AC/ CC 基因型患者（P <0.05）。结论邯郸地区汉族人群ACAT-1位点 rs1044925基因多态性与冠心病患者血清LDL-C和HDL-C水平有关，ACAT-1位点 rs1044925基因多态性可能通过影响血脂代谢而参与冠心病的发生和发展。%Objective To investigate the correlation between ACAT-1 rs1044925 gene polymorphism and blood lipid metabolism of patients with coronary heart disease in Han population in Handan. Methods In 2015 in the First Department of Cardiology,the First Hospital of Handan,a total of 396 inpatients with coronary heart disease were selected as case group,a total of 428 subjects with normal coronary arteriography examination results were selected as control group. PCR - RFLP was used to analyze the gene polymorphism of ACAT-1 rs1044925. BMI,blood lipids index,gene types and allele distribution of ACAT-1 rs1044925 were compared between the two groups;blood lipids index was compared in patients and subjects with different gene types. Results BMI,serum levels of TG,TC,LDL-C,nHDL-C and lipoprotein( a) of case group were statistically significantly higher than those of control group,while serum HDL-C level of case group was statistically significantly lower than that of control group(P < 0. 05);no statistically significant differences of serum level of ApoA1 or ApoB was found between the two groups(P > 0. 05). No statistically significant difference of gene type,A allele distribution or C allele distribution was found between the two groups(P > 0. 05). Of control group,no statistically significant differences of serum level of TC,TG, LDL-C,nHDL-C,LDL-C,ApoA1 ,ApoB or lipoprotein(a)was found in subjects with different gene types(P > 0. 05). Of case group,no statistically significant differences of level of TC,TG,nHDL-C,ApoA1 ,ApoB or lipoprotein(a)was found in patients with different gene types(P > 0. 05);serum HDL-C level of patients with AA gene type was statistically significantly lower than that of patients with AC gene type or CC gene type,respectively,while serum LDL-C level of patients with AA gene type was statistically significantly higher than that of patients with AC gene type or CC gene type,respectively(P < 0. 05);after correction of gender,age and BMI,covariance analysis results showed that,serum HDL-C level of patients with AA gene type was statistically significantly lower than that of patients with AC gene type or CC gene type,respectively,while serum LDL-C level of patients with AA gene type was statistically significantly higher than that of patients with AC gene type or CC gene type, respectively(P < 0. 05). Conclusion Gene polymorphism of ACAT-1 rs1044925 is correlated with serum levels of LDL-C and HDL-C of patients with coronary heart disease in Han population in Handan,it may play an important role in the genesis and development of coronary heart disease through influencing the blood lipid metabolism.