三種血脂基因多態(tài)性與冠心病和缺血性卒中的關(guān)系研究
本文選題:MAFB基因 + 單核苷酸多態(tài)性; 參考:《廣西醫(yī)科大學(xué)》2016年博士論文
【摘要】:第一部分MAFB基因多態(tài)性與冠心病及缺 背景:冠心病與卒中是目前世界上死亡率和致殘率最高的一種復(fù)雜的多因素疾病,遺傳及環(huán)境因素在其發(fā)病中發(fā)揮著一定的作用。近年來全基因組關(guān)聯(lián)研究發(fā)現(xiàn)和篩選出的一系列與脂代謝及動脈粥樣硬化相關(guān)A易感基因或突變,但多為歐美人群的研究或者后期的重復(fù)驗證結(jié)果,缺乏中國人群的資料,部分易感位點在中國人群中尚未涉及。MAFB基因多態(tài) 脂代謝有關(guān),但其與冠心病及缺血 動脈粥樣硬化相關(guān)A易感 ,在中國人群中亦缺少研究資料。目的:觀察MAFB基因多態(tài)-rs2902940、rs6102059在廣西漢族人群中的等位基因頻率與基因型分布,探討其與血脂水平的影響,以及與冠心病及缺血 方法:本研究是基于廣西地區(qū)漢族群體的病例-對照研究,共收集1604例樣本,其中冠心病組525例,缺血 540例,對照組539例。以問卷調(diào)查形式收集研究對象的一般信息及臨床資料,提取全血基因組DNA。采用SNa Pshot SNP分型技術(shù)對兩個MAFB基因SNPs位點rs2902940和rs6102059進(jìn)行基因分型。比較病例組與對照組之間等位基因及基因型頻率分布的差異,計算基因型與冠心病及缺血 ,并分析基因型與血脂水平的關(guān)系。結(jié)果:CAD及IS組MAFB rs2902940 SNP基因型頻率與對照組比較有顯著差異(P0.05),而該位點的等位基因頻率差異僅在CAD與對照組有統(tǒng)計學(xué)意義(P0.05)。MAFB rs2902940 SNP AA基因型或攜帶A等位基因增加CAD的發(fā)病風(fēng)險(AA基因型:OR=1.63,95%CI=1.07-2.48,P=0.023;A等位基因:OR=1.22,95%CI=1.01-1.48,P=0.036)。GA、AA基因型增加IS的發(fā)病風(fēng)險相關(guān)(GA基因型:OR=1.76,95%CI=1.14-2.71,P=0.011;AA基因型:OR=1.69,95%CI=1.09-2.61,P=0.017)。GA/AA基因型亦與增加CAD及IS風(fēng)險相關(guān)(CAD:OR=1.56,95%CI=1.04-2.32,P=0.030 for GA/AA vs.GG;IS:OR=1.72,95%CI=1.14-2.60,P=0.010for GA/AA vs.GG)。分層分析顯示,男 ≤60歲、高BMI、以及飲酒、伴有高血壓、糖尿病的個體中,攜帶rs2902940 GA/AA基因型的個體較之GG基因型者有更高的CAD及IS罹患風(fēng)險;該位點與高BMI、高血壓和糖尿病這些危險因素之間存在交互作用。對照組人群的MAFB rs2902940 SNP各基因型間血清Apo AI水平的比較差異具有統(tǒng)計學(xué)意義(P=0.018),GA/AA基因型比GG基因型者有著更低的Apo AI水平(P=0.024)。結(jié)論:MAFB rs2902940 SNP GA/AA基因型比GG基因型者有著更低的Apo AI水平,攜帶rs2902940 GA/AA基因型的個體較之GG基因型者有更高的CAD及IS罹患風(fēng)險。MAFB基因多態(tài) 粒相關(guān)聯(lián),與冠心病和缺血 有關(guān)。第二部分FADS1/FADS2基因簇與冠心病及缺 背景:長鏈多不飽和脂肪酸(LC-PUFAs)對心腦血管有一定程度的保護(hù)作用,FADS1、FADS2基因分別編碼合成LC-PUFA的限速酶△-5去飽和酶和△-6去飽和酶。FADS1/FADS2基因簇多態(tài) CAD和IS易感多以及血漿脂質(zhì)水平亦有相關(guān) 全一致。目的:FADS1 rs174546 SNP和FADS2 rs174601 SNP在廣西漢族人群中的等位基因頻率與基因型分布,探討其與冠心病及缺血 關(guān)系,且與脂代謝的相關(guān) 方法:本研究以廣西地區(qū)漢族群體的病例-對照的研究方式,入選研究對象1669例,對照組582例,病例組1087例(CAD:534例,IS:553例)。選擇FADS1 rs174546 SNP和FADS2 rs174601 SNP兩個位點采用SNa Pshot SNP分型技術(shù)進(jìn)行基因分型,比較病例組與對照組之間等位基因及基因型頻率分布的差異,計算基因型與冠心病及缺血 相關(guān) 粒結(jié)果:廣西地區(qū)漢族群體中FADS1 rs174546 SNP和FADS2 rs174601SNP T等位基因及TT基因型頻率分布所占的比率高。CAD及IS組FADS1 rs174546 SNP和FADS2 rs174601 SNP等位基因及基因型頻率與對照組比較有顯著差異(P0.05)。FADS1 rs174546 SNP和FADS2rs174601 SNP T等位基因與增加CAD及IS的發(fā)病風(fēng)險相關(guān)(rs174546SNP:OR=1.30,95%CI=1.06-1.59 for CAD,OR=1.29,95%CI=1.06-1.57 for IS;rs174601 SNP:OR=1.38,95%CI=1.13-1.69 for CAD,OR=1.42,95%CI=1.16-1.73 for IS)。相應(yīng)的,兩個SNPs C等位基因攜帶與減少CAD及IS的發(fā)病風(fēng)險相關(guān)(rs174546 SNP:OR=0.57,95%CI=0.44-0.75for CAD,OR=0.62,95%CI=0.48-0.80 for IS;for rs174601 SNP:OR=0.54,95%CI=0.41-0.70 for CAD,OR=0.61,95%CI=0.48-0.79 for IS)。單體型分析示單體型T-T(rs174546-rs174601)與增加IS的發(fā)病風(fēng)險相關(guān)(OR=1.32,95%CI=1.10-1.59),而單體型C-C(rs174546-rs174601)與減少CAD及IS的發(fā)病風(fēng)險相關(guān)(OR=0.72,95%CI=0.60-0.87 for CAD,OR=0.76,95%CI=0.63-0.91 for IS)。CAD組rs174601 TT基因型比CC/TC基因型有著較低血清TC、HDL-C和Apo AI水平(P0.025)。而在IS組,rs174546和rs174601 TT/TC基因型較CC基因型者有著較低的血清HDL-C和Apo AI水平(P0.025)。結(jié)論:FADS1 rs174546 SNP和FADS2 rs174601 SNP T等位基因及單體型T-T(rs174546-rs174601)與增加CAD及IS的發(fā)病風(fēng)險相關(guān)。相對應(yīng)的,C等位基因及與單體型C-C(rs174546-rs174601)減少CAD及IS的發(fā)病風(fēng)險。FADS1/FADS2基因簇多態(tài) FADS1 rs174546 SNP和FADS2 rs174601 SNP TT/TC基因型和FADS2rs174601 SNP TT基因型有著較低的血清HDL-C和Apo AI水平,可能是增加CAD和IS的發(fā)病風(fēng)險的原因。第三部分ANGPTL4基因多態(tài)性與冠心病及缺 背景:血管生成素樣蛋白4(ANGPTL4)為血管生成素樣蛋白家族成員。與脂代謝有著非常密切的關(guān)系,在動脈粥樣硬化相關(guān)A過程中起著重要的作用。目前ANGPTL4與血脂水平、動脈粥樣硬化相關(guān)A ANGPTL4基因多態(tài) 不盡一致,尤其缺乏中國人群的相關(guān)資料。開展ANGPTL4基因多態(tài) 血脂及人類動脈粥樣硬化相關(guān)疾病的關(guān)系的研究有助于了解ANGPTL4在動脈粥樣硬化中的作用,將為脂代謝、動脈粥樣硬化相關(guān)疾病的靶向治療提供更多新思路。目的:本文旨在探討ANGPTL4 SNPs rs2967605、rs4076317、rs7255436和rs1044250對血脂水平的影響,以及與動脈粥樣硬化相關(guān)疾病即CAD和IS發(fā)病風(fēng)險的關(guān)系。方法:基于廣西地區(qū)漢族群體的病例-對照研究,共收集1654例樣本,其中冠心病組568例,缺血 537例,對照組549例。采用SNa Pshot SNP分型技術(shù)對rs2967605、rs4076317、rs7255436和rs1044250 4個ANGPTL4SNPs進(jìn)行基因分型。比較病例組與對照組之間等位基因及基因型頻率分布的差異,計算基因型與冠心病及缺血 ,并分析基因型與血脂水平的關(guān)系。結(jié)果:4個ANGPTL4 SNPs中,只有rs2967605 SNP的對照組與病例組基因型頻率分布有顯著差異(P0.05)。rs2967605 SNP CT/TT基因型與減少CAD及IS的發(fā)病風(fēng)險相關(guān)(CAD:OR=0.68,95%CI=0.47-0.99 for CT/TT vs.CC;IS:OR=0.55,95%CI=0.38-0.80 for CT/TT vs.CC)。分層分析顯示該位點的保護(hù)效應(yīng)主要體現(xiàn)在年齡≤60歲(CAD:OR=0.50,95%CI=0.27-0.95,P=0.035;IS:OR=0.37,95%CI=0.20-0.68,P=0.002),高BMI(CAD:OR=0.53,95%CI=0.28-0.99,P=0.049;IS:OR=0.52,95%CI=0.27-0.99,P=0.048),高血壓人群(CAD:OR=0.37,95%CI=0.18-0.76,P=0.007;IS:OR=0.42,95%CI=0.21-0.84,P=0.015)和高脂血癥人群(CAD:OR=0.37,95%CI=0.18-0.75,P=0.006;IS:OR=0.32,95%CI=0.16-0.65,P=0.001)。該位點與女 BMI、飲酒和糖尿病這些因素存在交互作用。ANGPTL4 SNPs的各種遺傳模式分析與CAD冠狀動脈病變嚴(yán)重程度無相關(guān) logistic回歸分析顯示高BMI、高血壓、高脂血癥和糖尿病為CAD的危險因素(P0.05),而女 P0.05)。在對照組人群中,ANGPTL4 rs4076317 SNP CG/CC基因型比GG基因型者具有較高的血清TC和LDL-C水平(P0.001)及較低的血清HDL-C水平(P=0.008)。未發(fā)現(xiàn)rs7255436、rs1044250、rs2967605基因型與血脂水平存在相關(guān) 結(jié)論:ANGPTL4 rs4076317 SNP與脂代謝相關(guān),ANGPTL4 rs4076317SNP rs4076317 CG/CC基因型比GG基因型有著較低的血清HDL-C水平和較高的血清TC、LDL-C水平。ANGPTL4 rs2967605 SNP與血脂水平無相關(guān) CAD和IS相關(guān),ANGPTL4 rs2967605 SNP CT/TT基因型較CC基因型對CAD及IS更具有保護(hù)效應(yīng)。ANGPTL4基因與CAD及IS的關(guān)系是復(fù)雜的,并不一定由血脂水平介導(dǎo),可能還有其它因素的參與。進(jìn)一步明確其功能具有重要意義。
[Abstract]:The first part of the MAFB gene polymorphism and coronary heart disease and the absence of background: coronary heart disease and stroke are a complex multifactor disease with the highest mortality and disability in the world. Genetic and environmental factors play a role in its pathogenesis. In recent years, a series of total genome association studies have been developed and screened with lipid metabolism and arteries. Atherosclerosis related A susceptibility gene or mutation, but most of the European and American population research or later repeated validation results, the lack of Chinese population data, some susceptible loci have not been involved in the.MAFB gene polymorphism of lipid metabolism in Chinese population, but its susceptibility to coronary heart disease and ischemic atherosclerotic A is also susceptible to the Chinese population. Objective: To observe the allele frequency and genotype distribution of MAFB gene polymorphism -rs2902940 and rs6102059 in Guangxi Han population, to explore the effects of the allele and the blood lipid level, as well as the methods of coronary heart disease and ischemia: This study was based on a case-control study of Han population in Guangxi region. A total of 1604 samples were collected, among them, crowns were collected. 525 cases of heart disease, 540 cases of ischemia and 539 cases in the control group. The general information and clinical data of the subjects were collected by questionnaire survey. The genomic DNA. of whole blood was extracted by SNa Pshot SNP typing technique, and the SNPs loci rs2902940 and rs6102059 were genotyping of the SNPs loci of the MAFB gene. The alleles and genotypes between the cases of the disease cases and the control group were compared. The difference in frequency distribution, the calculation of genotype and coronary heart disease and ischemia, and the relationship between genotypes and blood lipid levels. Results: the genotype frequencies of MAFB rs2902940 SNP in CAD and IS groups were significantly different from those of the control group (P0.05), but the difference in allele frequency of the loci was statistically significant (P0.05).MAFB rs2902940 SNP in CAD and the control group (P0.05). The AA genotype or A allele increases the risk of CAD (AA genotype: OR=1.63,95%CI=1.07-2.48, P=0.023; A alleles: OR=1.22,95%CI=1.01-1.48, P=0.036).GA, and AA genotype increases the risk associated with IS. It is also related to increasing the risk of CAD and IS (CAD:OR=1.56,95%CI=1.04-2.32, P=0.030 for GA/AA vs.GG; IS:OR=1.72,95%CI=1.14-2.60, P=0.010for GA/AA vs.GG). The risk of D and IS was associated with the risk factors of high BMI, hypertension and diabetes. The comparison of the serum Apo AI levels between the MAFB rs2902940 SNP genotypes of the control group was statistically significant (P=0.018), and the GA/AA genotypes had lower Apo levels than those of the GG genotype. The 2902940 SNP GA/AA genotype has a lower Apo AI level than that of the GG genotype. The individuals carrying the rs2902940 GA/AA genotype have higher CAD and IS associated with the risk.MAFB gene polymorphisms of the GG genotypes, which are associated with coronary heart disease and ischemia. The second part of the FADS1/FADS2 gene cluster is associated with coronary heart disease and the absence of background: long chain polyunsaturated Fatty acids (LC-PUFAs) have a certain protective effect on the cardiovascular and cerebral vessels. FADS1, FADS2 genes encode the speed limiting enzyme Delta -5 desaturase and delta -6 desaturase.FADS1/FADS2 gene cluster polymorphism CAD, IS susceptibility and plasma lipid levels, respectively. The allele frequency and genotype distribution of the Han population in Guangxi, and the relationship with coronary heart disease and ischemia, and the related methods of lipid metabolism: in this study, 1669 cases were selected, 582 cases in the control group, 1087 cases in the control group (CAD:534 cases, IS:553 cases), and the choice of FADS1 rs17454 in the case control study of Han population in the region of Guangxi. 6 SNP and FADS2 rs174601 SNP loci were genotyping by SNa Pshot SNP typing. The difference of allele and genotype frequency distribution between the case group and the control group was compared. The results of the genotype and coronary heart disease and ischemia related particles were calculated: the FADS1 rs174546 SNP and FADS2 rs174601SNP alleles in the Han population in Guangxi region The frequencies of the frequency distribution of TT genotype and.CAD and the FADS1 rs174546 SNP and FADS2 rs174601 SNP alleles and genotype frequencies of the IS group were significantly different from those of the control group (P0.05) CAD, OR=1.29,95%CI=1.06-1.57 for IS; rs174601 SNP:OR=1.38,95%CI=1.13-1.69 for CAD, OR=1.42,95%CI=1.16-1.73 for IS). .41-0.70 for CAD, OR=0.61,95%CI=0.48-0.79 for IS). The haplotype analysis shows that the somatotype T-T (rs174546-rs174601) is associated with the risk of increasing IS (OR=1.32,95%CI=1.10-1.59), while the somatotype C-C (rs174546-rs174601) is associated with the risk of reducing the onset of the disease. The rs174601 TT genotype has lower serum TC, HDL-C and Apo AI levels (P0.025). In the IS group, rs174546 and rs174601 TT/TC genotypes are lower than those of the genotype. The risk of increasing the risk of CAD and IS. Corresponding, C allele and C-C (rs174546-rs174601) decrease the risk of CAD and IS The causes of the risk of CAD and IS. Third part ANGPTL4 gene polymorphism and coronary heart disease and lack of background: angiopoietin like protein 4 (ANGPTL4) is a member of the angiopoietin like protein family. It has a very close relationship with lipid metabolism and plays an important role in the process of atherosclerosis related A. At present, ANGPTL4 and blood lipid level, movement The polymorphism of the A ANGPTL4 gene associated with atherosclerosis is not consistent, especially in the Chinese population. The study of the relationship between ANGPTL4 gene polymorphisms and human atherosclerosis related diseases will help to understand the role of ANGPTL4 in atherosclerosis, and will be the target of lipid metabolism and atherosclerosis related diseases. Treatment provides more new ideas. Objective: This article aims to explore the effects of ANGPTL4 SNPs rs2967605, rs4076317, rs7255436 and rs1044250 on blood lipid levels, and the relationship with the risk of atherosclerotic disease, CAD and IS. Methods: a total of 1654 samples were collected from the Han population in Guangxi, including coronary heart disease. There were 568 cases, 537 cases of ischemia and 549 cases of control group. SNa Pshot SNP typing was used to genotyping rs2967605, rs4076317, rs7255436 and rs1044250, and the difference of allele and genotype frequency distribution between the case group and the control group was compared, the genotype and coronary heart disease and ischemia were calculated, and the genotype and blood lipid water were analyzed. Results: in 4 ANGPTL4 SNPs, there was a significant difference in the genotype frequency distribution between the control group of the rs2967605 SNP and the case group (P0.05) the.Rs2967605 SNP CT/TT genotype was related to the risk of decreasing CAD and IS. The protective effects of the loci were mainly reflected in the age less than 60 years (CAD:OR=0.50,95%CI=0.27-0.95, P=0.035; IS:OR=0.37,95%CI=0.20-0.68, P=0.002), high BMI (CAD:OR=0.53,95%CI=0.28-0.99, P=0.049; IS:OR=0.52,95%CI=0.27-0.99, P=0.048), and high blood pressure population (CAD: OR=0.37,95%CI=0.18-0.76, P=0.007; P=0.002) and Hyperlipidemia (CAD:OR=0.37,95%CI=0.18-0.75, P=0.006; IS:OR=0.32,95%CI=0.16-0.65, P=0.001). The loci and women BMI, drinking, and diabetes have the interaction of the various genetic patterns of.ANGPTL4 SNPs analysis and the severity of coronary artery disease without a correlation of logistic regression analysis showing high BMI, high blood pressure, high fat blood. In the control group, the ANGPTL4 rs4076317 SNP CG/CC genotype had higher serum TC and LDL-C levels than those of the GG genotype (P0.001) and the lower serum HDL-C level in the control group. ANGPTL4 rs4076317 SNP is associated with lipid metabolism, and ANGPTL4 rs4076317SNP rs4076317 CG/CC genotype has a lower serum HDL-C level and a higher serum TC than GG genotype. The relationship between the protective effect of.ANGPTL4 gene and CAD and IS is complex, and it is not necessarily mediated by blood lipid levels, and may be involved in other factors. Further clarifying its function is of great significance.
【學(xué)位授予單位】:廣西醫(yī)科大學(xué)
【學(xué)位級別】:博士
【學(xué)位授予年份】:2016
【分類號】:R743.3;R541.4
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