血浆纤溶酶原激活物抑制因子-1基因启动子多态性与2型糖尿病、高血压病、冠心病的关系

目的：探讨中国人群中血浆纤溶酶原激活物抑制因子－1（PAI－1）基因变异和2型糖尿病（DM）、高血压病、冠心病的关系。方法：对281例门诊及住院病例，根据口服糖耐量试验（OGTT）为非DM（糖耐量正常者，糖耐量低减者）和2型DM组，并根据血压分为高血压病（HT）组和非高血压病（NGT）组分。分析他们PI－1基因启动子多态性，结果：2型DM者和非DM者相比；PAI－1基因型频率及等位基因频率有明显的统计学差异（X^2分别为6．0和6．3，P＜0．05），在DM组中冠心病者和非冠心病者相比；冠心病者PAI－1基因型频率及等位基因频率具有明显的统计学差异（X^2分别为6．9和7．6，P＜0．05和P＜0．01）；非条件多因素Logistic回归发现：冠心病和年龄有显著关系（P＜0．001），与PAI－1基因多态性也有显著意义（P＜0．01），与肥胖也有明显意义（P＜0．05）。结论：PAI－1基因启动子多态性可能是冠心病的遗传因素；PAI－1基因突变可能是2型DM并发冠心病的危险因素，年龄，肥胖可能是冠心病的危险环境因素。

The Relationship among Polymorphism of Promotor of PAl-1 Gene, Type 2 Diabetes Mellitus, Hypertension and Coronary Heart Disease

Objective: To explore the relationship between polymorphism of PAI-1 gene and type 2 diabetes mellitus(DM), hypertension, and,coronary heart disease. Methods: The polymorphism of plasminogen activator inhibitor-1 (PAI-1)gene was analyzed by PCR technique in 281 subjects. Results: The frequency of 4G/4G genotype and 4C allele of PAI-1 in type 2 diabetic patients were increased compared with non-diabetic subjects(x2 =6. 0 and 6. 3 respectively, P < 0. 05). In DM group, the frequency of 4G/4G genotype and 4G allele of PAI-1 in patients with coronary heart disease were significantly increased than in patients without coronary heart disease (X2 = 6. 9 and 7. 6 respectively, P < 0. 05, P < 0. 01 respectively). In the model of multiple factors non-conditional logistic regression analyses, coronary heart disease related to age, obesity and polymorphism of PAI-1 ( P < 0. 001, P < 0. 05, P < 0. 01 respectively). Conclusion: These results suggested that the 4G allele of PAI-1 gene might be a risk factor of type 2 diabetes disease complicated with coronary heart disease.