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目的探讨哈萨克族高血压的环境和遗传危险因素及其交互作用。方法通过现场问卷调查和体格检查获取个人基本资料,在此基础上,选择573例无血缘关系个体,高血压261人(男/女=111/150),平均年龄52.16±12.38岁;对照组312人(男/女=121/191),平均年龄40.91±14.27岁。通过病例-对照相关分析,应用聚合酶链反应(PCR)鉴定血管紧张素转换酶(ACE)基因插入/缺失多态性的频率分布;应用Logistic回归模型分析遗传与环境因素的交互作用。结果 (1)血脂测定显示,高血压组血清TG,TC,Apo-A,Apo-B,肌酐和尿酸水平明显高于对照组(P<0.05);而HDL-C低于对照组(P=0.0145)。(2)以ACE基因的DD基因型为参照,ID基因型的OR为1.200(95%Ci=0.789-1.825,P=0.3947)。(3)多因素Logistic回归分析结果表明,年龄、BMI和ACE基因都进入回归模型,明显增加高血压的危险性(P<0.05),Apo-A与BMI和ACE基因型存在交互作用。结论本文研究结果表明,年龄、肥胖(BMI>24kg/m~2)和高血脂是哈萨克族高血压的重要环境危险因素;ACE基因Ⅱ基因型和Ⅰ等位基因可大大增加高血压的危险性。
Objective To investigate the environmental and genetic risk factors and their interactions in Kazakh hypertension. Methods According to the questionnaires and physical examinations, 573 unrelated individuals and 261 high blood pressure (male / female = 111/150) were selected. The average age was 52.16 ± 12.38 years old. The control group 312 Person (male / female = 121/191), with an average age of 40.91 ± 14.27 years. Through case-control analysis, the frequency distribution of ACE gene insertion / deletion polymorphism was identified by polymerase chain reaction (PCR). The interaction between genetic and environmental factors was analyzed by Logistic regression model. The serum levels of TG, TC, Apo-A, Apo-B, creatinine and uric acid in hypertension group were significantly higher than those in control group (P <0.05) 0.0145). (2) According to the DD genotype of ACE gene, OR of ID genotype was 1.200 (95% Ci = 0.789-1.825, P = 0.3947). (3) Multivariate logistic regression analysis showed that age, BMI and ACE genes all entered the regression model, significantly increasing the risk of hypertension (P <0.05). There was interaction between Apo-A and BMI and ACE genotypes. Conclusions The results of this study indicate that age, obesity (BMI> 24 kg / m ~ 2) and hyperlipidemia are important environmental risk factors for Kazakh hypertension. ACE genotype Ⅱ and Ⅰ allele may significantly increase the risk of hypertension .