血管紧张素转换酶基因多态性与疾病易感性的关系

机体血管紧张素转换酶（ＡＣＥ）水平受ＡＣＥ基因插入／缺失（Ｉ／Ｄ）多态性影响，缺失型纯合子（ＤＤ型）ＡＣＥ接近插入型纯合子（ＩＩ型）的两倍。ＤＤ型为糖尿病肾病，急性心肌梗塞的易患因素。     

血管紧张素转换酶基因多态性与疾病易感性的关系

机体血管紧张素转换酶（ＡＣＥ）水平受ＡＣＥ基因插入／缺失（Ｉ／Ｄ）多态性影响，缺失纯合子（ＤＤ型）ＡＣＥ接近插入型纯合子（ＩＩ型）的两倍。ＤＤ型为糖尿病肾病，急性心肌梗塞的易患因素。     

血管紧张素转换酶基因多态性与中国人冠心病的关联研究

目的 探讨血管紧张素转换酶（ＡＣＥ）基因多态性在中国人冠心病发生发展中的作用。方法 应用聚合酶链反应技术和遗传学方法，测定１５９例中国汉族正常人，１４８例冠心病患者的ＡＣＥ原因插入／缺失（Ｉ／Ｄ）多态性频率。结果 （１）中国汉族正常人ＤＤ，ＩＤ，Ⅱ基因型频率分别为０．１５７，０．５３５和０．３０８，（２）冠心病组及其心肌梗塞，心绞痛亚组ＡＣＥ基因型分布与正常相比差异均有显著性（Ｐ〈０．０５），其Ｄ     

血管紧张素转换酶基因与女性Ⅱ型糖尿病患者冠心病的关系探讨

目的探讨血管紧张素转换酶（ＡＣＥ）基因插入／缺失（Ｉ／Ｄ）多态性与Ⅱ型糖尿病患者心血管并发症的关系。方法应用聚合酶链式反应（ＰＣＲ）法对２２５例Ⅱ型糖尿病患者和１００例正常人ＡＣＥ基因多态性的分布进行研究，并结合临床及生化指标进行分析。结果在Ⅱ型糖尿病患者中，ＤＤ型冠心病的发病率明显高于Ｉ型和ＩＤ型（Ｐ＜００５）。以性别分层后，这种差异只在女性患者中有显著性（Ｐ＜００５）。非条件ｌｏｇｉｓｔｉｃ回归分析证实，在女性Ⅱ型糖尿病患者中，ＤＤ基因型为并发冠心病（ＣＨＤ）的独立危险因素，而在男性患者中未得出同样结论。结论ＡＣＥ基因插入／缺失多态性是女性Ⅱ型糖尿病患者中合并冠心病的独立危险因素。提示糖尿病患者中，对女性ＤＤ型患者早期施以ＡＣＥ抑制剂可能会防止冠心病的发生。     

冠心病患者血管紧张素转换酶基因多态性及其与血清血管紧张素转换酶水平的关系

为研究冠心病患者血管紧张素转换酶（ACE）基因插入／缺失（I／D）多态性分布及其与血清ACE水平的相关性，应用多聚酶链反应方法测定了61例冠心病患者和63例健康人群的ACE基因I／D多态性，并采用微量比色法测定其血清ACE水平。结果发现，冠心病患者ACE基因DD型出现频率显著高于对照组，且DD基因型者具有较高的血清ACE水平。提示ACE基因I／D多态性与血清ACE水平密切相关，DD型ACE基因可能是中国人冠心病发病的独立危险因子。     

血管紧张素转换酶基因插入/缺失多态性与盐敏感性高血压病发生的关系

目的：研究血管紧张素转换酶（ＡＣＥ）基因插入／缺失多态性与盐敏感性高血压病发生的关系。方法：用ＡＣＥ基因第１６内含子多态性两侧的序列设计引物，用多聚酶链反应来检测８０例高血压病患者（其中盐敏感性高血压病患者５０例，盐不敏感性高血压病患者３０例）和９０例正常人ＡＣＥ基因插入／缺失多态性。结果：Ｄ及Ｉ型等位基因频率在高血压病患者与正常对照组之间无差异，Ｄ及Ｉ型等位基因频率在盐敏感性高血压病患者与盐不敏感性高血压病患者之间也无差异。结论：ＡＣＥ基因插入／缺失多态性与中国人高血压病以及与盐敏感性之间无相关关系。     

血管紧张素转化酶基因的插入/缺失多态性与其血清水平及心肌梗塞的关系

旨在探讨中国人中血管紧张素转化酶（ＡＣＥ）基因的插入／缺失（ｉｎｓｅｒｔｉｏｎ／ｄｅｌｅｔｉｏｎ，Ｉ／Ｄ）多态性与血清中ＡＣＥ水平及心肌梗塞的关系。心肌梗塞患者１０３例；正常对照９６例。位于ＡＣＥ基因第１６内含子的Ｉ／Ｄ多态性经ＰＣＲ扩增可分为三种基因型：纯合缺失型（ＤＤ），纯合插入型（Ｉ），杂合子型（ＩＤ）。血清ＡＣＥ水平在ＤＤ、ＤＩ、Ｉ型分别为２８．３±９．９Ｕ／ｍｌ、２４．５±８．４Ｕ／ｍｌ、１９．２±４．８Ｕ／ｍｌ，即ＤＤ＞ＤＩ＞ⅠⅠ。结果显示，心肌梗塞患者的Ｄ等位基因的频率（０．６１）高于正常对照组（０．４８），Ｐ＜０．０１。认为：ＡＣＥ基因的缺失多态性与中国人血清ＡＣＥ水平及心肌梗塞相关。     

血管紧张素转换酶基因多态性与2型糖尿病患者脑梗塞的关系

目的探讨血管紧张素转换酶（ＡＣＥ）基因多态性与２型糖尿病脑梗塞间的关系。方法应用多聚酶链反应（ＰＣＲ）技术,对１０９名２型糖尿病患者及５２名正常对照者的ＡＣＥ基因插入／缺失（Ｉ／Ｄ）型多态性进行检测,并用Ｌｏｇｉｓｔｉｃ多元逐步回归,筛选出２型糖尿病患者脑梗塞的高危因素。结果（１）糖尿病总组ＡＣＥ基因型频率和等位基因频率与正常对照组无显著性差异（Ｐ＞０．０５）。（２）糖尿病脑梗塞组ＡＣＥ基因ＤＤ型和Ｄ等位基因频率显著高于非脑梗塞组（Ｐ＜０．０１）及正常对照组（Ｐ＜０．０５）。（３）多元逐步回归分析显示：ＡＣＥ基因ＤＤ型、Ｄ等位基因、脂蛋白（ａ）及年龄是糖尿病脑梗塞的独立危险因素,而ＡＣＥ基因ＩＩ型和Ｉ等位基因则为２型糖尿病脑梗塞的保护因子。结论ＡＣＥ基因Ｉ／Ｄ多态性与２型糖尿病脑梗塞的发病密切相关。ＡＣＥ基因     

冠心病与血管紧张素转换酶及其基因

肾素－血管紧张素系统（ＲＡＳ）与冠心病，ＭＩ的关系一直受到重视。随着分子生物学技术的不断进步，血管紧张素转换酶（ＡＣＥ）的基因结构及功能得以进一步阐明。并发现位于１６内含子的ＣＥ基因插入／缺乏多态性影响血清ＡＣＥ活性，与ＭＩ具相关性。     

血管紧张素转换酶基因多态性与原发性高血压的关系

目的：探讨中国人血管紧张素转换酶（ＡＣＥ）基因的插入／缺失（Ｉ／Ｄ）多态性与原发性高血压（ＥＨ）发病的相关性。方法按ＷＨＯ标准确诊的ＥＨ患者６８例，正常对照组６２例。用多聚酶链式反应（ＰＣＲ）和琼脂糖电泳技术，检测两组个体ＡＣＥ基因的Ｉ／Ｄ多态性。结果高血压组与正常对照组检测出３例基因Ⅱ、ⅠＤ和ＤＤ，频率分布分别为０．４８、０．３７、０．１５和０．３９、０．４８、０．１３，Ｉ、Ｄ等位基因频率分别为     

血管紧张素转化酶基因插入/缺失多态性与冠心病发病的关系

目的 :探讨血管紧张素转化酶 (ACE)基因多态性与冠心病 (CHD)发病的关系。方法 :以人基因组DNA为模板 ,应用聚合酶链式反应 (PCR)检测 5 0例CHD组和 5 6例正常对照组ACE基因第 16内含子插入 /缺失 (I/D)多态性 ,并按性别分组计算各组基因型和等位基因频率。结果 :①在CHD组中 ,ACE基因DD基因型和D等位基因频率分别为 36 %和 6 0 % ,正常对照组分别为 16 %和 4 1% ,两者相比差异有统计学意义 (P <0 .0 1)。②男性CHD组DD基因型和D等位基因频率均显著高于对照组 (均P <0 .0 5 )。女性CHD组DD基因型频率显著高于对照组 (P <0 .0 1) ,D等位基因频率与对照组比较差异无统计学意义。结论 :CHD与ACE基因I/D多态性有显著相关性 ,不论男性和女性 ,ACE基因DD基因型均可能是CHD发生发展过程中重要的危险因素之一。     

高血压人群中ACE、ADRB1基因多态性与冠状动脉狭窄程度的相关性研究

目的探讨高血压人群中血管紧张素转换酶(ACE)基因多态性及β1肾上腺素能受体(ADRB1)基因多态性与冠状动脉(冠脉)狭窄程度的相关性。方法选取2017年7月至2019年4月于徐州医科大学附属医院心血管内科住院的280例高血压患者的临床资料进行回顾性分析,行冠脉造影或冠脉CT血管造影(CTA)检查判定其是否患有冠心病(CHD),并依据结果判定其冠脉病变支数及给予Gensini评分。根据冠脉检查结果将上述患者分为CHD组(n=145)和对照组(n=135)。所有入选病例均给予了ACE及ADRB1基因多态性检测,并根据结果分为ACE II型纯合子、ID型杂合子、DD型纯合子和ADRB1 GG型纯合子、GC型杂合子、CC型纯合子。结果在研究的高血压人群中,ACE DD基因型携带者在冠脉病变支数中的多支病变组及Gensini得分分组中的重度病变组的占比明显高于ACE II及ACE ID基因型(P<0.05);ADRB1基因多态性在冠脉病变支数分组及Gensini得分分组的对比中无明显相关性(P>0.05);CHD组与对照组一般临床资料对比中显示年龄、高密度脂蛋白胆固醇(HDL-C)和糖尿病与CHD存在相关性,且有统计学意义(P<0.05)。结论ACE基因多态性与高血压人群冠状动脉狭窄程度密切相关,ADRB1基因多态性无明显相关性。     

血管紧张素转换酶基因多态性对冠心病患者血管内皮舒张功能的影响

目的:观察血管紧张素转换酶(ACE)基因多态性对冠心病患者内皮功能的影响及其抑制剂的干预作用.方法:选取冠心病患者(冠心病组)68例,对照组69例,聚合酶链反应(PCR)检测ACE基因插入/缺失(L/D)多态性,超声检测肱动脉内皮功能.结果:冠心病组DD基因型明显高于对照组.冠心病组ACE各基因型内皮依赖性舒张功能均低于对照组,DD基因型最为明显;非内皮依赖性舒张功能差异无显著性.血管紧张素转换酶抑制剂(ACEI)治疗后冠心病组各型肱动脉内皮依赖性舒张功能与治疗前比较均有显著性改善,其中DD基因型改善最为明显.结论:冠心病患者血管内皮功能异常与ACE基因I/D多态性相关.ACEI可以改善内皮功能,特别是对DD基因型患者改善更为明显.     

ACE gene polymorphism and coronary restenosis.

In humans, circulating levels of angiotensin-converting enzyme (ACE) are linked with an insertion (I)/deletion (D) polymorphism in the ACE gene: DD genotype bearers have higher levels of ACE than either ID or II genotype bearers. Recent studies have suggested that the ACE DD genotype might be associated with a higher risk of coronary artery disease. The aim of this paper is to review studies on the influence of the I/D polymorphism on coronary restenosis. The renin-angiotensin system has been implicated in the pathogenesis of neointimal hyperplasia in experimental models. In humans, the I/D polymorphism is not associated with restenosis after balloon angioplasty, but is strongly associated with restenosis after coronary stent implantation. This may be explained by the fact that the contribution of neointimal hyperplasia to restenosis is much more important after coronary stent implantation than after balloon angioplasty.     

Angiotensin I-converting enzyme (ACE) inhibitors and restenosis after coronary artery stenting in patients with the DD genotype of the ACE gene

OBJECTIVES: We tested the hypothesis that patients with the DD genotype of the angiotensin I-converting enzyme (ACE) gene who are treated with ACE inhibitors are at a higher risk of restenosis after coronary stent placement than patients who do not receive ACE inhibitors. BACKGROUND: Two recent studies with a limited series of patients carrying the DD genotype suggested an unfavorable impact of the use of ACE inhibitors on the restenotic process after implantation of stents in coronary arteries. Because these findings may question the use of ACE inhibitors after coronary stenting, we examined this important issue in a large series of patients. METHODS: We determined the ACE gene I/D genotype of 2,222 consecutive patients with symptomatic coronary artery disease who underwent stent implantation. The patients with the DD genotype (n = 612) constituted the study population. The primary end point was in-stent restenosis, which was assessed as angiographic restenosis (> or =50% diameter stenosis at six-month follow-up) and clinical restenosis (need for target vessel revascularization due to symptoms or signs of ischemia in the presence of angiographic restenosis over one year after the intervention). RESULTS: Of the 612 patients with the DD genotype, 403 (65.8%) were treated with ACE inhibitors and 209 (34.2%) did not receive ACE inhibitors. The angiographic and clinical restenosis rates were not significantly different between the group treated with ACE inhibitors and the group not receiving ACE inhibitors (p = 0.55). Continuous measures of restenosis, minimal lumen diameter, diameter stenosis, late lumen loss, and loss index were also similar in both groups (p > or = 0.55). In addition, one-year survival free of myocardial infarction was not significantly different between the two groups (p = 0.27). CONCLUSIONS: In contrast to previous reports, our study provides evidence that patients carrying the DD genotype are not exposed to an increased risk of restenosis after stent placement when treated with ACE inhibitors.     

Angiotensin converting enzyme gene polymorphisms and coronary risk in a Portuguese population]

BACKGROUND: A family history of coronary heart disease (CHD) is a strong risk marker for the disease, independently of classical risk factors. It could be decoded by recognizing the polymorphisms associated with increased risk. Renin-angiotensin system genes are candidate genes in CHD and the deletion allele of the angiotensin converting enzyme (ACE) has been reported as deleterious. However, there is disagreement as to the role of the insertion/deletion polymorphism of the ACE gene in coronary risk. AIM: To evaluate whether ACE gene polymorphisms constitute a CHD risk factor. METHODS: We conducted a population-based case-control study of 301 subjects with a history of myocardial infarction or angiographic evidence of coronary heart disease and 510 age- and gender-matched controls, without CHD, living in a region with high CHD mortality rates. Blood samples were taken, DNA extracted and genotypes determined by the polymerase chain reaction (PCR). Amplification products were identified by agarose gel electrophoresis. STATISTICAL ANALYSIS: The Data were evaluated by SPSS for Windows, using the Student's t test, the chi-square test, odds ratios and 95% confidence intervals. RESULTS: The prevalence of the DD, ID and II genotype was 41.2%, 46.3%, 12.5% in the cases and 28.1%, 55.2% and 16.7% in the control group. The frequency of the DD genotype was significantly higher in the cases than in the controls (41.2% vs. 28.1%, odds ratio 1.79, 95% CI 1.31 to 2.4, p < 0.0001). By contrast, the ID and II genotypes' prevalence was higher in the control group (55.2% vs. 46.3%, p = 0.002 and 16.7 vs. 12.5%, p = NS, respectively) compared to the case group. CONCLUSIONS: This study clearly shows that the ACE DD polymorphism is strongly linked to CHD, and if our data are confirmed in a larger population sample, more aggressive vascular prevention could be justified in patients carrying the DD genotype.     

Renin-angiotensin system gene polymorphisms: assessment of the risk of coronary heart disease

BACKGROUND: Renin-angiotensin system genes are candidate genes in cardiovascular system diseases. Angiotensinconverting enzyme (ACE), angiotensinogen (AGT) and angiotensin II type 1 receptor (AT1R) gene polymorphisms are considered risk factors in coronary heart disease (CHD). AIM: To evaluate the involvement of the ACE, AGT and AT1R genetic variants in predisposition to CHD as well as their association with other known risk factors. METHODS: The study included 400 male subjects (200 with CHD and 200 healthy individuals). Genotypes were determined by a polymerase chain reaction (PCR). For the AGT and AT1R genes a restriction analysis of the PCR product was performed. The allele frequency and genotype distribution were compared between groups. RESULTS: The allele and genotype frequencies of the ACE gene were similar in both groups, however, a significantly higher frequency of the DD genotype was observed in the presence of hyperlipidemia (39% vs 24% in non-hyperlipidemic subjects, p<0.01). The AGT gene polymorphism was associated with the development of CHD. The T allele was significantly more frequent in patients than in the control group (55% vs 44%, p<0.05). The heterozygous MT genotype was observed in 61% of patients compared to 40% in the controls (p<0.05). The A1166C polymorphism of the AT1R gene was also associated with CHD as well as with age at the onset of disease. The frequency of the C allele was 29% compared to 21% in the control group (p<0.01) and the frequency of the CC homozygote was almost three times higher in patients. CONCLUSIONS: There is an association between molecular variants of the angiotensinogen and angiotensin II type 1 receptor and increased risk of CHD. The DD genotype of the ACE gene polymorphism and the TT genotype of the AGT gene polymorphism were significantly more frequent in patients with hyperlipidemia. The TT genotype of the AGT gene M235T polymorphism was associated with an increased risk of CHD and myocardial infarction only in smokers.     

血管紧张素转换酶基因多态性与冠脉病变严重程度的相关性研究

目的探讨血管紧张素转换酶(ACE)基因I/D多态性与冠心病及冠脉病变严重程度的关系.方法对122例冠心病患者进行冠状动脉造影,判定冠脉病变支数(狭窄程度≥75%)和危险记分.用聚合酶链式反应(PCR)技术检测病例组和80例健康人群ACE基因多态性.结果ACE基因型分布和等位基因频率在病例组和对照组间差异有显著性,病例组DD基因型(38.5%)和D等位基因频率(55%)显著高于对照组(13.7%,41%;P＜0.05).冠脉病变支数和危险记分在ACE基因型间差异无显著性(P＞0.05).结论ACE基因多态性中DD型和D等位基因是冠心病发病的独立危险因素,但与冠脉病变严重程度不相关.