原发性高血压患者血清脂联素及其基因多态性与冠心病的相关性研究

【摘要】目的探讨原发性高血压患者血清脂联素水平及其基因单核苷酸多态性（SNP）rs266729、rs7649121、 rs1501299、rs3774262与冠心病及冠脉病变程度的关系。方法以高血压患者414例（其中单纯高血压患者180例，高血压合并冠心病患者234例）和正常对照组185例为研究对象，应用酶联免疫吸附法（ELISA）测定血清脂联素水平，聚合酶链反应-限制性片段长度多态性（PCR-RFLP）法检测脂联素rs266729、rs7649121、rs1501299、rs3774262位点多态性。结果高血压合并冠心病组脂联素水平较对照组和单纯高血压组显著降低。脂联素rs7649121位点杂合子AT基因型较AA基因型可降低冠心病风险（校正OR=0.566，95%CI0.346~0.925，P=0.023）。多元Logistic回归分析显示年龄、LDL-C为冠心病的危险因素，脂联素为冠心病的保护因素。随着病变支数增加，脂联素水平呈逐渐降低趋势。脂联素SNP位点基因型对血清脂联素水平无明显影响。结论脂联素水平降低是高血压患者发生冠心病的独立危险因素，且随着冠脉病变程度的加重，脂联素水平逐渐降低。脂联素rs7649121位点多态性可能与高血压患者并发冠心病有关。

The Association between Serum Adiponectin Levels and Gene Polymorphism with Coronary Artery Disease in Patients with Essential Hypertension

Abstract] Objective To observe the association between adiponectin gene polymorphism, serum adiponectin lev? els with the incidence of coronary artery disease (CAD) and the severity of coronary artery stenosis in patients with essential hypertension (EH).Methods A total of414patients with EH (234cases with CAD and180cases without CAD) and185 control subjects were recruited in this study. Serum adiponectin levels were measured by enzyme-linked immunosorbent as? say (ELISA). Adiponectin single- nucleotide polymorphisms rs266729，rs7649121，rs1501299and rs3774262were geno? typed by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Results Serum adiponectin levels were significantly lower in EH with CAD group than those in control group and EH without CAD group. Adiponectin SNP rs7649121AT genotype reduced the risk of CAD compared with AA genotype (adjustedOR=0.566，95%CI0.346-0.925，P=0.023). Logistic regression analysis showed that age and LDL-C were risk factors of CAD, and adiponectin was the protective factor for CAD in EH patients. The severity of coronary artery stenosis was negatively related to the level of adipo? nectin. Adiponectin levels were not affected by the adiponectin gene polymorphism.Conclusion The decreased serum adi? ponectin level was the independent risk factor for CAD in EH patients, which was negatively related to the severity of coro? nary artery stenosis. Adiponectin SNP rs7649121may contribute to the risk factors of CAD in EH patients.