Hokanson J E
Department of Medicine, University of Washington, Seattle, USA.
Curr Opin Lipidol. 1999 Oct;10(5):393-9. doi: 10.1097/00041433-199910000-00003.
The current report is a quantitative review of the relationship between lipoprotein lipase gene variants and cardiovascular disease based on published population-based studies. Sixteen studies, representing 17,630 individuals, report allelic distribution for lipoprotein lipase gene variants among patients and control individuals. Patient outcomes included clinical cardiovascular disease events, documented coronary disease based on angiography, or intimal media thickening by B-mode ultrasonography. Mantel-Haenszel stratified analysis was used to compute a summary odds ratio and 95% confidence intervals for the association between rare allele in the lipoprotein lipase gene and disease status. Because of potential differing effects associated with different lipoprotein lipase variants, each lipoprotein lipase mutant allele was considered separately. The lipoprotein lipase D9N/-93G to T allele has a summary odds ratio of 2.03 (95% confidence interval 1.30-3.18), indicating a twofold increase in risk of coronary disease for carriers with this allelic variant. The summary odds ratio for the relationship of the rare lipoprotein lipase G188E variant with cardiovascular disease is 5.25 (95% confidence interval 1.54-24.29). The lipoprotein lipase N291S allele is associated with a marginal increase in cardiovascular disease (summary odds ratio 1.25, 95% confidence interval 0.99-1.60, P = 0.07). However, there is stronger evidence for a positive association in certain populations. The summary odds ratio for lipoprotein lipase S447X allele is 0.81 (95% confidence interval 0.65-1.0), which indicates a cardioprotective effect of this lipoprotein lipase gene variant. Thus, lipoprotein lipase gene variants are associated with differential susceptibility to cardiovascular disease.
本报告是基于已发表的人群研究对脂蛋白脂肪酶基因变异与心血管疾病之间关系进行的定量综述。16项研究涉及17630名个体,报告了患者和对照个体中脂蛋白脂肪酶基因变异的等位基因分布情况。患者的结局包括临床心血管疾病事件、基于血管造影的确诊冠心病或通过B型超声检查的内膜中层增厚。采用Mantel-Haenszel分层分析来计算脂蛋白脂肪酶基因中罕见等位基因与疾病状态之间关联的汇总比值比及95%置信区间。由于不同的脂蛋白脂肪酶变异可能存在不同的效应,因此对每个脂蛋白脂肪酶突变等位基因分别进行了分析。脂蛋白脂肪酶D9N / -93G至T等位基因的汇总比值比为2.03(95%置信区间1.30 - 3.18),表明携带该等位基因变异的个体患冠心病的风险增加了两倍。罕见的脂蛋白脂肪酶G188E变异与心血管疾病关系的汇总比值比为5.25(95%置信区间1.54 - 24.29)。脂蛋白脂肪酶N291S等位基因与心血管疾病的轻微增加相关(汇总比值比1.25,95%置信区间0.99 - 1.60,P = 0.07)。然而,在某些人群中有更强的证据支持正相关。脂蛋白脂肪酶S447X等位基因的汇总比值比为0.81(95%置信区间0.65 - 1.0),这表明该脂蛋白脂肪酶基因变异具有心脏保护作用。因此,脂蛋白脂肪酶基因变异与心血管疾病的易感性差异有关。