血管紧张素转换酶2350G/A及胃促胰酶基因多态性与高血压左心室肥厚的相关研究

目的探讨血管紧张素转换酶(ACE)2350G/A及胃促胰酶基因多态性在高血压伴左心室肥厚(left ventricular hypertrophy,LVH)、高血压人群、健康体检者中的分布,探讨高血压患者LVH发生的分子遗传机制。方法选取高血压住院患者205例,根据有无LVH,分为LVH组105例和原发性高血压组100例;同时选取健康体检者101例作为对照组,利用PCR-RFLP进行检测ACE2350G/A及胃促胰酶基因CMA/B多态性。结果与对照组比较,LVH组ACE2350基因AA基因型(25.7%vs 13.9%)和A等位基因频率(51.4%vs 39.6%)均明显升高,差异有统计学意义(P<0.05)。各组CMA/B基因G、A等位基因频率比较,差异无统计学意义(P>0.05)。结论 ACE2350基因多态性与高血压患者LVH发生显著相关,AA基因型增加LVH的发生风险,A等位基因频率为LVH发生的危险基因。CMA/B基因与高血压患者LVH发生无显著相关性。     

血管紧张素转换酶基因和糜酶抑制剂基因多态性与原发性高血压患者左室肥厚的相关性研究

目的探讨血管紧张素转换酶(ACE)基因插入/缺失(I/D)多态性和Chymase(CMA)基因A/B多态性与原发性高血压患者左室肥厚的关系.方法应用聚合酶链反应(PCR)和限制性片断长度多态性方法(RFLP)检测了1042例原发性高血压患者ACE基因I/D多态性以及CMA基因A/B多态性;同时超声心动测量左室舒张末期内径(LVDd)、舒张期室间隔厚度(IVST)及左室后壁厚度(LVPWT).结果①ACE基因II、ID、DD基因型及I、D等位基因频率在原发性高血压合并左室肥厚组(LVH)与无左室肥厚组(NLVH)间的分布差异无统计学意义;②CMA基因AA、AB、BB基因型及A、B等位基因频率在LVH组与NLVH组间的分布差异无统计学意义;③ACE和CMA基因型间年龄、体质指数(BMI)、脉搏、收缩压(SBP)、舒张压(DBP)、LVDd、IVST、LVPWT、LVM以及LVMI差异均无统计学意义;④ACE和CMA基因型与左室肥厚(LVH)不相关;⑤ACE基因中各基因型与CMA基因中各基因型间不存在交互作用.结论 ACE基因I/D多态性及CMA基因A/B多态性与原发性高血压患者左室肥厚不相关.     

ADRB1和ACE基因多态性与左心室肥厚的相关性研究

目的 探讨原发性高血压(EH)左心室肥厚(LVH)患者中β₁肾上腺素受体(ADRB1)、血管紧张素转换酶(ACE)基因多态性的作用。方法 根据《中国高血压防治指南》(2018年修订版)选取EH住院患者80例，对EH患者进行心脏超声检查，分为LVH(LVH+)组33例和非LVH(LVH-)组47例。收集两组患者临床资料，取外周血使用基因芯片技术检测各自的基因多态性位点，比较两组患者性别、年龄、体重指数、肝肾功能、血糖、血脂以及基因型和等位基因频率。结果 两组间性别、年龄、体重指数、空腹血糖、高密度脂蛋白胆固醇、肝功能及血压等比较无显著性差异(P>0.05)。LVH+组ADRB1 CC基因型及C等位基因频率高于LVH-组(P<0.05),LVH+组ACE ID基因型频率及D等位基因频率高于LVH-组(P<0.05)。ADRB1与ACE敏感基因型联合分析，联合基因型分布频率在LVH+组与LVH-组间无显著性差异(P>0.05)。结论 ADRB1 C/G多态性与LVH发病相关，CC基因型及C等位基因携带可能是LVH发病危险因素；ACE I/D多态性...     

血管紧张素转换酶2基因A9570G多态性与高血压合并左心室肥厚的相关性研究

目的探讨血管紧张素转换酶2基因(ACE2)A9570G多态性与高血压合并左心室肥厚的关系。方法选择高血压合并左心室肥厚(LVH)患者172例(LVH组)、高血压未合并LVH患者153例(NLVH组)以及对照组80例,应用聚合酶链反应(PCR)方法检测入选者ACE2基因A9570G多态性,按性别分别比较不同组别中基因型分布及等位基因频率的差异。结果在女性,3组间等位基因频率比较差异有统计学意义(P=0.007),基因型分布差异也有统计学意义(P=0.034),其中LVH组GG基因型及G等位基因频率分别为30.0%和61.0%,高于NLVH组(18.7%和44.8%)及对照组(15.0%和40.0%)。在男性,3组间等位基因/基因型频率比较差异有统计学意义(P=0.002),其中LVH组G基因型/等位基因频率为69.0%,高于NLVH组(47.6%)及对照组(40.0%)。结论 ACE2基因A9570G多态性与高血压患者左心室肥厚相关。     

血管紧张素转换酶基因和糜酶抑制剂基因多态性与原发性高血压患者左室肥厚的相关性研究

目的 探讨血管紧张素转换酶(ACE)基因插入／缺失(I／D)多态性和Chyrnase(CMA)基因A／B多态性与原发性高血压患者左室肥厚的关系。方法 应用聚合酶链反应(PCR)和限制性片断长度多态性方法(RFLP)检测了：1042例原发性高血压患者ACE基因I／D多态性以及CMA基因A／B多态性；同时超声心动测量左室舒张末期内径(LVDd)、舒张期室间隔厚度(IVST)及左室后壁厚度(LVPWT)。结果 ①ACE基因II、ID、DD基因型及I、D等位基因频率在原发性高血压合并左室肥厚组(LVH)与无左室肥厚组(NLVH)间的分布差异无统计学意义；②CMA基因AA、AB、BB基因型及A、B等位基因频率在LVH组与NLVH组间的分布差异无统计学意义；③ACE和CMA基因型间年龄、体质指数(BMI)、脉搏、收缩压(SBP)、舒张压(DBP)、LVDd、IVST、LVPWT、LVM以及LVMI差异均无统计学意义；④ACE和CMA基因型与左室肥厚(LVH)不相关；⑤ACE基因中各基因型与CMA基因中各基因型间不存在交互作用。结论 ACE基因I／D多态性及CMA基因A／B多态性与原发性高血压患者左室肥厚不相关。     

醛固酮合成酶基因多态性与高血压及左室肥厚的关系

目的：本研究旨在观察血管紧张素转换酶（ACE）基因I／D多态性和醛固酮合成酶（CYP11B2）基因－344C／T多态性与高血压（EH）及左室肥厚（LVH）的相关性。方法：将136例原发性高血压病患者分为LVH组72例,无LVH组64例;应用多聚酶链式反应（PCR）、限制性内切酶方法检测ACE和CYP11B2基因的多态性。结果：（1）无LVH组LVH组ACE基因I／D多态性基因型和等位基因分布差异均有显著性（P＜0．05）,LVH组Ⅱ基因型和Ⅰ等位基因频率显著高于无LVH组。（2）无LVH组与LVH组CYP11B2基因－344C／T多态性基因型和等位基因分布差异均有显著性（P＜0．05）,LVH组CT基因型和C等位基因频率显著高无LVH组。（3）LVH组中的CT＋Ⅱ联合基因型频率高于无LVH组（P＜0．05）。结论：（1）ACE型I／D和CYP11B2基因－344C／T多态性与高血压发生无相关性。（2）ACE基因Ⅱ多态性与LVH相关。(3）CYP11B2基因－344CT基因型与LVH相关。（4）CYP11B2基因－344CT基因型和ACE基因Ⅱ基因型共存对LVH的发病具有协同作用。     

扩张型心肌病与血管紧张素转换酶基因、chymase基因多态性的研究

目的 :探讨血管紧张素转换酶 (ACE)基因插入 /缺失 (I/D)多态性及chymase(CMA)基因B种A/G多态性是否是扩张型心肌病 (DCM )的易感性标志。 方法 :采用聚合酶链反应 (PCR)和限制性片段长度多态性方法 (RFLP)检测 4 3例DCM患者和 6 3例健康者中ACE基因I/D多态性和CMA/B基因A/G多态性的频率分布 ,同时超声心动图测量左心室内径 (LVDd、LVDs)大小 ,计算射血分数 (EF)值 ,测量心胸比、血压和心率等临床指标。结果 :①ACE基因II、ID、DD基因型及I、D等位基因频率在DCM组与对照组的分布差异无显著性意义。②CMA基因AA、AG、GG基因型及A、G等位基因频率在DCM组与对照组的分布差异无显著性意义。③ACE、CMA基因型间年龄、患病史、NYHA心功能分级、LVDd、LVDs、EF值、心胸比、心率、收缩压、舒张压差异无显著性意义。④ACE、CMA基因型与LVDd、LVDs、EF值不相关。结论 :ACE基因I/D多态性及CMA/B基因A/G多态性与DCM患者心脏大小及收缩功能不相关。     

ACE2基因多态性与原发性高血压的关系

目的 研究血管紧张素转化酶2（angiotensin converting enzyme 2,ACE2）基因多态性与广东地区原发性高血压的相关性.方法 高血压组选择门诊与住院的汉族无血缘关系的原发性高血压369例,男194例,女175例;对照组为同期体检的广东地区健康汉族居民199例,男101例,女98例.排除冠心病、高血压、糖尿病、脑血管病及肝功能不良、肾功能不良.按照性别分为两组,采用病例对照的原则,应用聚合酶链反应和限制性内切酶片段长度多态性（polymerase chain reaction and restriction fragment length polymorphism,PCR-RFLP）的方法检测ACE2基因G9570A多态性,并随机抽取20份标本进行基因测序以核实基因分型.在分析各亚组的年龄、体重指数、血压及生化指标的基础上综合分析ACE2基因多态性与原发性高血压的关系.结果 高血压组G等位基因频率：男75.3%,对照组男60.4%,差异有统计学意义（χ2=7.0086,P=0.0081）,高血压组,女57.4%,对照组45.4%,差异有统计学意义（χ2=6.9443,P=0.0084）;女高血压组GG基因型的频率明显高于对照组（χ2=12.9499,P=0.0015）;G等位基因人群发生高血压的风险高于A等位基因人群,男OR：1.9945,95% CI：1.1916～3.3385,P=0.0082;女OR：1.603,95% CI：1.1274～2.2792,P=0.0085.结论 ACE2-G9570A多态性与原发性高血压相关;携带G等位基因的男性和仅仅携带G基因的女性人群发生高血压的危险性相对较大,提示ACE2基因可作为原发性高血压的候选易感基因.     

Klotho基因多态性与高血压左室肥厚的关系

目的 探讨klotho基因G395A多态性与高血压左室肥厚的关系.方法 原发性高血压患者76例,为单纯高血压组(A组),高血压左室肥厚组82例(B组),对照组69例(C组).采用聚合酶链反应(PCR)及基因芯片技术检测各组人群的G395A位点基因多态性.结果 Klotho基因G395A多态性GG、GA、AA在三组的分布频率有显著差异(x2=16.976,P＜0.05).单纯高血压组A等位基因频率高于对照组(36.85％ vs 26.09％,P＜0.05).高血压左室肥厚组各基因型分布频率与对照组相比差异有统计学意义(x2=14.307,P＜0.05),A等位基因频率高于对照组(47.56％ vs 26.09％,P＜0.05).结论 高血压左室肥厚组AA基因型频率增加,提示klotho基因G395A多态性可能与高血压及左室肥厚的发生有关.     

ACE、AT1R基因多态性与孕龄期子宫内膜异位症患者遗传易感性的关系

目的：探讨血管紧张素转换酶（ACE）基因A2350G、血管紧张素Ⅱ1型受体（AT1R）基因A1166C多态性与孕龄期妇女Ⅲ、Ⅳ期子宫内膜异位症（ Ems）遗传易感性的关系。方法以Ⅲ、Ⅳ期Ems患者78例（病例组）及非Ems患者82例（对照组）为研究对象。采用PCR-RFLP技术分析两组ACE基因A2350G、AT1R基因A1166C多态性分布。结果病例组ACE基因A2350G基因型AA、AG、GG携带率分别为62．82％、34．62％、2．56％,A、G等位基因分布频率分别为80．13％、19．87％;对照组分别为86．59％、12．20％、1．20％和92．68％、7．32％;P均＜0．05。病例组AT1R基因A1166C基因型AA、AC携带率分别为85．90％、14．10％,A、C等位基因分布频率为92．95％、7．05％;对照组分别为87．80％、12．20％和93．90％、6．10％;P均＞0．05。结论携带ACE基因G等位基因的孕龄期妇女患Ⅲ、Ⅳ期Ems的危险性增加,AT1R基因多态性可能不是Ems发生的独立危险因素。     

Angiotensin-converting enzyme gene 2350 G/A polymorphism is associated with left ventricular hypertrophy but not essential hypertension.

The angiotensin-converting enzyme (ACE) gene (ACE) is one of the most studied candidate genes related to essential hypertension (EH) and left ventricular hypertrophy (LVH). ACE rs4343 synonymous coding polymorphism (2350 G/A) is known among the polymorphisms of this gene to have the most significant effect on plasma ACE concentrations. The aim of the present study was to investigate the association of this polymorphism with EH and LVH in 440 subjects (246 EH patients and 194 controls) from a Chinese Han population. In this study, 2350 G/A genotypes were identified by polymerase chain reaction and restriction digestion in all study participants, and left ventricular mass was assessed by 2-mode echocardiography in 178 untreated EH patients. There was no significant difference in either genotype distribution (p=0.3659) or allele frequency (p=0.1453) between EH and control groups. In addition, the 2350 G/A polymorphism had no effect on blood pressure in either controls or untreated EH patients. The distribution of genotypes differed significantly when patients with LVH were examined, i.e., 14.71% GG, 54.41% GA, and 30.88% AA patients had this complication, and 36.36% GG, 42.73% GA, and 20.91% AA patients did not (p=0.0070). The LVH patients had a higher A allele frequency (58.09%) than patients without LVH (42.27%) (p=0.0037). Logistic regression analysis revealed that the association between the A allele and LVH was independent of age, blood pressure, and body mass index. The relative risk of LVH in patients bearing the A allele (GA+AA group) compared with that of GG hypertensive patients was 3.31 (95% confidence interval [CI]: 1.43 to 7.68). These findings suggest an association between LVH and the 2350A allele in hypertensive patients.     

Plasminogen activator inhibitor-1 (PAI-1) 4G/5G and angiotensin converting enzyme (ACE) I/D gene polymorphisms and fibrinolytic activity in patients with essential hypertension and dyslipidemia

Essential arterial hypertension often predisposes patients to prothrombotic state and increased risk of vascular and organ complications. Vital role in regulation of hemostatic processes is played by genetic factors, renin-angiotensin system and disorders of lipid metabolism. Prime genetic factors involved in the process are 4G/5G polymorphism of promoter region coding tissue plasminogen activator inhibitor-1 (PAI-1) and I/D polymorphism for angiotensin converting enzyme (ACE) gene. The aim of work was the evaluation of alterations within fibrinolysis system (estimation of t-PA and PAI-1 levels), fibrinogen concentration (Fb) and ACE activity with regard to co-existent dyslipidemia and features of left ventricle hypertrophy (LVH). Moreover the analysis of influence of 4G/5G PAI and I/D ACE gene polymorphism on intensification of aforementioned alterations among hypertensive patients was performed. Research was carried out in 170 subjects under 40 years old, in two study groups, HT-- hypertensive group--125 patients with previously untreated hypertension without clinical features of ischaemic heart disease and NT--45 normotensive, healthy subjects. HT group has been further divided into four subgroups: DLP (dyslipidemic, n = 51), NLP (normolipidemic n = 74), LVH+ (with features of left ventricle hypertrophy, n = 35), LVH (-) (without features of left ventricle hypertrophy, n = 90). In a whole HT group significantly higher levels of PAI-1, t-PA and Fb were noted in comparison to NT group, considerably more pronounced within DLP rather than NLP subgroups. Moreover, pronounced increase in ACE activity was recorded in DLP and LVH+ subgroups. It has been proved that 4G/4G homozygous subjects of 4G/5G PAI-1 gene polymorphism from HT group tend to present higher levels of PAI-1 and t-PA if contrasted to 4G/4G genotype of NT group, with more distinct effect within DLP subgroup. Carriers of D allele (genotypes I/D, D/D) of I/D ACE gene polymorphism from HT group characterise with significantly higher activity of ACE in contrast to I/I genotype of HT group, with particularly marked effect in DLP and LVH+ subgroups. Basing on above mentioned results it may be concluded that essential hypertension (especially if complicated with dyslipidemia) impairs fibrinolysis, what might be related to renin-angiotensin system activation in lipid metabolism disorders. Deletion alleles of 4G/5G polymorphism (4G allele) and I/D polymorphism (D allele) in patients with hypertension independently modify fibrinolysis towards prothrombotic state with more distinct effect in dyslipidemia. Increased activity of ACE in D allele carriers may predispose to left ventricle hypertrophy.     

Association of angiotensin converting enzyme gene polymorphisms with left ventricular hypertrophy.

The angiotensin converting enzyme gene (ACE) is of much interest as a candidate gene conferring an individual's genetic susceptibility to left ventricular hypertrophy (LVH). LVH has long been thought to be an end point of essential hypertension (EH), rather than a separate entity, though it is influenced by a unique set of hormonal, vascular and genetic factors. In this study, we attempted to determine whether two representative polymorphisms of the ACE gene, ACE I/D and 2350 G>A, known to be associated with EH and to have a highly significant influence on plasma ACE levels, could implicate ACE as a quantitative trait locus (QTL) for LVH. We carried out a retrospective, case-control study of the two ACE polymorphisms amongst 180 nationals (50 LVH patients and 130 controls) from the United Arab Emirates (Emirati)--an ethnic group characterized by an absence of alcohol intake and cigarette smoking--for putative correlations with LVH. Clinical diagnoses of LVH were based on echocardiographic and ECG criteria. ACE I/D and 2350 G>A genotypes were determined by polymerase chain reaction (PCR) and restriction digestion. Univariate and multivariate logistic regression analyses revealed an association between ACE polymorphisms and LVH. Haplotype analysis further supported this finding. The ACE I/D and ACE 2350 G>A polymorphisms were in strong linkage disequilibrium and were independently associated with LVH, suggesting that ACE is likely to be a QTL for LVH. In conclusion, This is the first association study of the ACE 2350 G>A polymorphism with LVH; the results showed that this polymorphism, along with ACE I/D, is associated with LVH.     

Polymorphic markers I/D and G7831A of angiotensin-I-converting enzyme gene and left ventricular hypertrophy in patients with essential hypertension

AIM: To elucidate possible association of angiotensin-I-converting enzyme (ACE) gene polymorphic markers I/D and G7831A with left ventricular hypertrophy (LVH) in patients with essential hypertension. MATERIAL: Patients with essential hypertension (n=123, 37 with and 86 without LVH, mean age 59.15+/-1.19 years). METHODS: Left ventricular (LV) mass was determined echocardiographically by Devereux method. Alleles and genotypes of ACE gene polymorphic markers were identified by polymerase chain reaction. RESULTS AND CONCLUSION: There was no association between I/D marker of ACE gene and LVH. Carriers of A allele compared with carriers of G allele of G7831A marker had significantly higher LV mass (284.1+/-10.20 g, and 248.5+/-14.42 g, respectively, p=0.033) and LV mass index (151.7+/-5.23 g/m2 and 131.0+/-6.74 g/m2, respectively; p=0.02). Among patients with LVH frequency of A allele was significantly higher than among patients without LVH (0.401 and 0.230, respectively; p=0.0065, OR=2.116 [1.197-3.7481]). Using binary logistic regression model we have found that presence of LVH was linked with age, sex and maximal systolic blood pressure (BP). Such factors as smoking, maximal diastolic BP, ordinary systolic and diastolic BP, duration of hypertension, coronary artery disease and diabetes were not related to LV mass index. Using multifactorial logistic regression model we have found that the presence of A allele of G7831A polymorphic marker of ACE gene, age and maximal systolic BP could be considered as independent risk factors of LVH.     

ACE I/D and G2350A Polymorphisms in Pakistani Hypertensive Population of Punjab

Several studies in different populations have shown mixed association of hypertension with ACE I/D and G2350A polymorphisms. To assess the link of these two polymorphisms with hypertension in population of Punjab—most populated province of Pakistan—we carried out this retrospective case control study in a mixed sample of 344 hypertensive and normotensive controls. Genotype of the ACE I/D was determined by nested PCR and G2350A. polymorphism was determined by amplification of a small fragment containing SNP and digesting it with the restriction enzyme. Statistical analysis revealed that I/D polymorphism is not associated with hypertension in the Punjabi population χ² (df = 2) = 5.611, P ≤ 0.10. Overall, D allele frequency was 0.43 and I allele frequency was 0.57. The G2350A polymorphism was found to be significantly associated with hypertension χ² (2df, χ² = 28.4, P ≤ 0.001). The G allele frequency (0.77) in our population was higher than previously reported. A combination of the AA and DD genotype seems to be linked with higher than average blood pressure level both in hypertensive and control groups. Our data suggests that the ACE I/D polymorphism is not associated with hypertension but the G2350A polymorphism is associated with hypertension in the Punjabi population.     

NADPH氧化酶p22phox亚基基因多态性与高血压左心室肥厚的相关性

目的 探讨中国汉族人群中NADPH氧化酶p22phox亚基C242T基因多态性与高血压左心室肥厚(LVH)的相关性.方法 连续收入初诊汉族原发性高血压患者286例,超声心动图评估并计算患者左心室质量指数,将患者分为单纯高血压和高血压合并LVH,并记录体质量指数、血压、血糖和血脂等.同时,采用限制性片段长度多态性鉴定p22phox亚基C242T基因型.结果 全部患者中均未检出TT基因型,而高血压合并LVH的患者中CT基因型(P=0.002)和T等位基因出现的频率(P=0.005)均显著高于单纯高血压患者.Logistic回归分析显示p22phox亚基C242T多态性与性别、收缩压同为高血压合并LVH的独立影响因素,存在T突变的高血压患者合并LVH的风险降低63%(P=0.007).结论 CYBA C242T多态性与中国汉族高血压患者LVH相关,T等位基因可能是LVH的保护因素.     

心钠素基因多态性与原发性高血压患者左心室肥厚的关系

目的 探讨人类心钠素（ANP）基因多态性与原发性高血压患者左心室肥厚的关系.方法 选择原发性高血压患者106例,根据心脏超声检查结果分为单纯高血压组（对照组）75例和高血压合并左心室肥厚组（观察组）31例,采用PCR技术检测人类ANP基因C664G、G1837A和T2238C位点的多态性,比较两组基因型及等位基因分布差异.结果 观察组患者人类ANP基因C664G位点GG基因型频率为54.8％,高于对照组的33.3％（P＜0.05）.两组患者人类ANP基因G1837A位点和T2238C位点基因型和各等位基因频率差异无统计学意义.结论 人类ANP基因C664G位点的基因变异可能与原发性高血压患者左心室肥厚有关.