AGT基因M235T变异与腰臀比异常对原发性高血压的影响

目的探讨AGT基因第二外显子编码M235T变异与腰臀比异常及其交互作用对原发性高血压的影响。方法对从青岛市4个社区中筛检出的、未经药物系统治疗的235例原发性高血压病人及240例正常血压者进行调查,用聚合酶链反应-限制性片段长度多态性(PCR-RFLP)方法检测M235T变异;应用相加模型分析M235T变异与腰臀比异常的交互作用。结果高血压组T等位基因频率(46.81%)及腰臀比异常率(69.79%)高于对照组(分别为37.71%,47.92%),差别有统计学意义(χ2=8.677,23.433,P0.01)。AGT基因M235变异与腰臀比异常具有正交互作用。用多因素分析调整年龄、性别、体质指数、饮酒、吸烟、血脂等因素后,M235T基因变异与腰臀比异常的协同效应指数(S)为1.945,归因交互效应(AB)为1.022,归因交互效应百分比(AP%)为32.91%,纯因子间AP为48.55%。结论 AGT基因第二外显子编码M235T变异与原发性高血压有关,AGT基因M235T变异与腰臀比异常具有正交互作用,控制腰臀比异常可以降低居民原发性高血压患病的危险性。

The Effect of M235T Mutation of the Angiotensinogen Gene and Abnormality of Waist-to-Hip Ratio on Essential Hypertension

Objective To analyze the effect of M235T mutation of coded protein by exon 2 in the angiotensinogen （AGT） gene, abnormality of waist-to-hip ratio （WHR）, and the interaction between these two factors on essential hypertension （EH）. Methods 235 EH patients without taking anti-hypertention medication and 240 normotension controls were randomly recruited from four communities in Qingdao. M235T mutation on exon 2 of AGT gene was detected by polymerase chain reaction-restriction fragment length polymorphism （PCR-RFLP）. Additive model was used to analyze the interaction between M235T mutation and abnormality of WHR. Results T allele frequency （46.81%） and abnormality of WHR （69.79%） in EH patients were significantly higher than those in controls （37.71%, 47.92%） （χ^2=8.677, 23.433, all P〈0.01）. M235T mutation of AGT gene and abnormality of WHR showed a positive interaction. After adjusted by the age, gender, alcohol drinking, smoking, body mass index and blood lipids, the logistic regression analysis results showed that the synergy index was 1.945, attributable interaction was 1.022, and attributable interaction percentage was 32.91%, pure attributable interaction percentage was 48.55%. Conclusion M235T mutation of the angiotensinogen gene and abnormality of WHR might serve as major susceptible factors for essential hypertension. M235T mutation of AGT gene and abnormality of WHR show a positive interaction. Proper control on abnormality of WHR might reduce the risk of getting essential hypertension in general population.