中国汉族冠心病患者乙醛脱氢酶2基因多态性与心肌梗死的相关性研究

目的：探讨汉族冠心病患者中乙醛脱氢酶2乙醛脱氢酶2(ALDH2)基因多态性与心肌梗死（MI）的相关性。方法:对231例冠心病患者采用多聚酶链反应分析ALDH2基因G487A多态性。并根据基因型分两组，ALDH2基因GG型组（n=145）和AA/AG型组（n=86），比较两组间MI发病率、心血管病传统危险因素和饮酒量等指标的差异，以评价MI的危险因素。结果:ALDH2基因AA/AG型组MI、糖尿病发病率明显高于GG型组，均有统计学意义（P＜0.01）。采用多因素logistic回归调整年龄、性别、吸烟、心血管病家族史、总胆固醇、糖尿病后，发现AA/AG型是MI的独立危险因素（OR=3.42, P＜0.01）,而在回归分析中再引入高血压病这一自变量后，AA/AG型与MI的相关性下降（OR＝3.03，P＝0.03），进一步引入饮酒量和高密度脂蛋白（HDL-C）两个自变量后，ALDH2基因型与MI间不再存在相关性（P＝0.23）。结论:ALDH2基因AA/AG型是MI的独立危险因素，其可能通过改变血压、饮酒量和HDL-C水平影响MI发病。

Correlation between Aldehyde dehydrogenase-2 gene polymorphisms and myocardial infarction in Chinese Han patients with coronary heart disease

Objective: To investigate the correlation between the G487A variant of aldehyde dehydrogenase-2(ALDH2) gene polymorphisms and myocardial infarction in Chinese Han patients with coronary heart disease.Methods: Two hundred and thirty-one patients with coronary heart disease,who were identified by coronary angiography,were enrolled in this study.The genotypes of ALDH2 were determined by the polymerase chain reaction and direct sequencing.The patients were divided into two groups according to the genotypes: the GG genotype group(n=145) and the AA/AG genotypes group(n=86).The differences between the two groups and the risk factors for myocardial infarction were assessed.Results: The prevalence of myocardial infarction and diabetes mellitus was significantly higher in the ALDH2 AA/AG genotypes group than in the GG genotype group(P<0.01),but other basic clinical data were similar between the two groups.After adjustment for age,sex,smoking,family history of cardiovascular disease,total cholesterol and diabetes mellitus using a multi-variable logistic regression,the AA/AG genotypes were an independent risk factor for myocardial infarction(OR=3.42,P<0.01).However,inclusion of hypertension as one of the independent variables downplayed the importance of the ALDH2 genotype(OR=3.03,P=0.03),and inclusion of hypertensi on,alcoholconsumption and HDL-cholesterol further downplayed the importance of the ALDH2 genotype(P=0.23).Conclusion: The ALDH2 AA/AG genotypes maybe an independent risk factor for myocardial infarction,which might be due to its influence on blood pressure,alcohol consumption and HDL-cholesterol.