血管紧张素转换酶（ACE）插入/缺失多态性与一组慢性血液透析患者的生存率

Angiotensin-converting enzyme (ACE) insertion/deletion polymorphism and survival in a cohort of chronic hemodialysis patients.

作者信息

Higashiuesato Y, Tana T, Tozawa M, Iseki C, Iseki K, Fukiyama K, Takishita S

机构信息

Third Department of Internal Medicine, University of the Ryukyus, Okinawa, Japan.

出版信息

Clin Nephrol. 2002 Nov;58(5):370-5. doi: 10.5414/cnp58370.

DOI:10.5414/cnp58370

PMID:12425488

Abstract

BACKGROUND

There are conflicting reports regarding the relationship between the angiotensin-converting enzyme (ACE) insertion/deletion (I/D) polymorphism and the initiation and progression of cardiovascular disease. Moreover, there is no report regarding the relationship between the ACE I/D polymorphism and the prognosis of chronic dialysis patients.

METHODS

We examined the frequency of the ACE I/D polymorphism in 727 chronic hemodialysis patients in Okinawa, Japan, and observed the prognosis over 2 years in 407 men and 320 women with mean age (SD) of 55.5 (13.9) years with a mean duration of dialysis of 84.3 (66.6) months.

RESULTS

Genotype frequencies were 42.1% for II, 43.2% for ID, and 14.7% for DD. The relative risks of death were examined by Cox-proportional hazards analysis after adjusting for age, sex, age at the start of dialysis, presence of diabetes mellitus and hypertension and total cholesterol and serum albumin levels. The adjusted hazard ratio (95% confidence interval) was 1.03 (0.38 - 2.85) for DD genotype and 1.50 (0.83 - 2.70) for DD+ID genotype when compared to II genotype.

CONCLUSION

ACE I/D polymorphism appears to have no relation to the short-term prognosis in chronic hemodialysis patients.

摘要

背景

关于血管紧张素转换酶（ACE）插入/缺失（I/D）多态性与心血管疾病的发生和发展之间的关系，存在相互矛盾的报道。此外，尚无关于ACE I/D多态性与慢性透析患者预后之间关系的报道。

方法

我们检测了日本冲绳727例慢性血液透析患者中ACE I/D多态性的频率，并观察了407例男性和320例女性患者的预后情况，这些患者的平均年龄（标准差）为55.5（13.9）岁，平均透析时间为84.3（66.6）个月，观察时间超过2年。

结果

基因型频率分别为：II型42.1%，ID型43.2%，DD型14.7%。在对年龄、性别、透析开始时的年龄、糖尿病和高血压的存在情况以及总胆固醇和血清白蛋白水平进行校正后，通过Cox比例风险分析检测死亡的相对风险。与II型基因型相比，DD基因型的校正风险比（95%置信区间）为1.03（0.38 - 2.85），DD + ID基因型的校正风险比为1.50（0.83 - 2.70）。