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目的探讨血管紧张素转换酶(ACE)基因I/D和A2350G多态性与环境因素交互作用对汉族原发性高血压的影响。方法基于人群为基础的病例-对照研究,从黑龙江省兰西县农村选取1010例原发性高血压患者和1030例正常对照;通过多聚酶链式反应-限制性片段长度多态性的方法对ACE基因两个位点(I/D和A2350G)进行多态性检测;基因多态性与环境因素交互作用的研究采用多因素Logistic回归分析。结果 ACE基因I/D和A2350G位点基因型在对照组中的分布均符合Hardy-Weinberg平衡(HWE)定律。多因素Logistic回归分析显示,年龄、性别、高血压家族史、体质指数(BMI)、甘油三酯和高密度脂蛋白胆固醇进入模型,为原发性高血压的危险因素(P<0.05),其中家族史尤为突出(χ~2=53.488,OR=2.140,95%CI 1.746~2.625)。通过两位点基因型与环境因素交互作用分析,发现两位点基因型与年龄、性别、BMI、甘油三酯和高密度脂蛋白胆固醇等因素均存在具有统计学意义的联合作用,仅发现I/D多态性与年龄存在相乘交互作用(P=0.0356,OR=1.021,95%CI 1.001~1.021)。结论 ACE基因I/D和A2350G多态性位点与多个环境因素存在联合作用,增加了患原发性高血压的风险。
Objective To investigate the effects of angiotensin converting enzyme (ACE) gene I / D and A2350G polymorphisms and environmental factors on essential hypertension in Han nationality. Methods Based on a population-based case-control study, 1010 essential hypertension patients and 1030 normal controls were selected from rural areas in Lanxi County, Heilongjiang Province. ACE inhibitors were amplified by polymerase chain reaction-restriction fragment length polymorphism Polymorphism was detected in two loci (I / D and A2350G). The interaction between genetic polymorphism and environmental factors was analyzed by multivariate logistic regression analysis. Results The distribution of ACE gene I / D and A2350G loci in the control group all accorded with Hardy-Weinberg equilibrium (HWE). Multivariate Logistic regression analysis showed that age, gender, family history of hypertension, body mass index (BMI), triglyceride and high density lipoprotein cholesterol were the risk factors of essential hypertension (P <0.05), among which Family history was particularly prominent (χ ~ 2 = 53.488, OR = 2.140, 95% CI 1.746 ~ 2.625). Through the interaction analysis between two genotypes and environmental factors, it was found that the genotypes of the two loci had statistical significance in combination with age, sex, BMI, triglyceride and high-density lipoprotein cholesterol, and only I / D polymorphism interacted with age (P = 0.0356, OR = 1.021, 95% CI 1.001 ~ 1.021). Conclusion The ACE gene I / D and A2350G polymorphism loci have multiple roles in combination with environmental factors, increasing the risk of developing essential hypertension.