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目的研究瘦素受体(leptin receptor,Lepr)基因多态性与云南省原发性高血压(高血压)合并肥胖汉族患者的相关性。方法选择2010年11月至2011年5月在云南省解放军昆明总医院住院的汉族高血压患者200例作为研究对象(高血压组)。另外,选取同期健康体检者100名作为正常对照组。将高血压组以体质量指数(BMI)≥28 kg/m2划分为肥胖高血压亚组141例和单纯高血压亚组59例。运用聚合酶链反应-限制性片段长度多态性(PCR-RELP)方法测定Lepr基因Gln223Arg多态性,酶联免疫吸附试验(ELISA)法测定血中瘦素浓度。采用彩色多普勒超声诊断仪测定颈动脉内膜-中层厚度(carotid intima-media thickness,CIMT)。结果 Lepr基因Gln223Arg基因型频率和等位基因频率在高血压组和对照组之间分布差异有统计学意义(P<0.05)。肥胖高血压亚组Lepr基因Gln223Arg等位基因A的频率明显高于单纯高血压组,差异有统计学意义[32.6%(92/141)vs.11.0%(13/59),P<0.01],并且肥胖高血压亚组AA+AG基因型患者比GG基因型患者有更高的体质量指数和CIMT,差异有统计学意义[(30.68±1.65)kg/m2 vs.(28.58±0.58)kg/m2,P<0.01;(0.69±0.06)mm vs.(0.61±0.06)mm,P<0.01]。Logistic回归分析结果显示,携带Gln223Arg基因A等位基因患者的体质量指数值的危险度是不含A等位基因患者的2.388倍(OR=2.388,P=0.015);携带A等位基因患者的高CIMT值的危险度是不含A等位基因患者的2.012倍(OR=2.012,P=0.042)。结论 Lepr基因Gln223Arg多态性与云南省高血压合并肥胖患者密切相关,且A等位基因携带者有更高的动脉粥样硬化危险性。
Objective To investigate the association of leptin receptor (Lepr) gene polymorphism with essential hypertension (hypertension) in Yunnan Han population. Methods 200 cases of Hypertension patients hospitalized in Kunming General Hospital of Yunnan Province from November 2010 to May 2011 were selected as the research object (hypertension group). In addition, select the same period 100 healthy subjects as a normal control group. Hypertension group was divided into body mass index (BMI) ≥28 kg / m2 into 141 cases of obesity and hypertension group and 59 cases of simple hypertensive subgroup. The polymorphism of Gln223Arg in Lepr gene was detected by polymerase chain reaction-restriction fragment length polymorphism (PCR-RELP) and the concentration of leptin in serum was detected by enzyme linked immunosorbent assay (ELISA). Carotid intima-media thickness (CIMT) was measured by color Doppler sonography. Results The genotype frequency and allele frequency of Lepr gene Gln223Arg were significantly different between hypertension group and control group (P <0.05). The frequency of allele A of Lepr gene in obese hypertensive subgroup was significantly higher than that in simple hypertensive group (32.6% (92/141) vs.11.0% (13/59), P <0.01] And the patients with AA + AG genotype had higher body mass index and CIMT than those with GG genotype in obese hypertensive subgroup [(30.68 ± 1.65) kg / m2 vs. (28.58 ± 0.58) kg / m2, P <0.01; (0.69 ± 0.06) mm vs. (0.61 ± 0.06) mm, P <0.01]. Logistic regression analysis showed that the risk of body mass index value of patients carrying the Gln223ArgA allele was 2.388-fold (OR = 2.388, P = 0.015), in patients with the A allele High CIMT value was 2.012 times more likely to be QR in the absence of the A allele (OR = 2.012, P = 0.042). Conclusion The Lepr gene Gln223Arg polymorphism is closely related to hypertension in obese patients in Yunnan Province, and the A allele carriers have a higher risk of atherosclerosis.