Cambien F, Poirier O, Lecerf L, Evans A, Cambou J P, Arveiler D, Luc G, Bard J M, Bara L, Ricard S
INSERM SC7, Paris, France.
Nature. 1992 Oct 15;359(6396):641-4. doi: 10.1038/359641a0.
Factors involved in the pathogenesis of atherosclerosis, thrombosis and vasoconstriction contribute to the development of coronary heart disease. In a study comparing patients after myocardial infarction with controls, we have explored a possible association between coronary heart disease and a variation found in the gene encoding angiotensin-converting enzyme (ACE). The polymorphism ACE/ID is strongly associated with the level of circulating enzyme. This enzyme plays a key role in the production of angiotensin II and in the catabolism of bradykinin, two peptides involved in the modulation of vascular tone and in the proliferation of smooth muscle cells. Here we report that the DD genotype, which is associated with higher levels of circulating ACE than the ID and II genotypes, is significantly more frequent in patients with myocardial infarction (n = 610) than in controls (n = 733) (P = 0.007), especially among subjects with low body-mass index and low plasma levels of ApoB (P < 0.0001). The ACE/ID polymorphism seems to be a potent risk factor of coronary heart disease in subjects formerly considered to be at low risk according to common criteria.
动脉粥样硬化、血栓形成和血管收缩发病机制中涉及的因素促使冠心病的发展。在一项比较心肌梗死后患者与对照组的研究中，我们探究了冠心病与血管紧张素转换酶（ACE）编码基因中发现的一种变异之间可能存在的关联。ACE/ID多态性与循环酶水平密切相关。这种酶在血管紧张素II的产生以及缓激肽的分解代谢中起关键作用，这两种肽参与血管张力调节和平滑肌细胞增殖。我们在此报告，与ID和II基因型相比，与循环ACE水平较高相关的DD基因型在心肌梗死患者（n = 610）中显著比对照组（n = 733）更常见（P = 0.007），尤其是在体重指数低和血浆载脂蛋白B水平低的受试者中（P < 0.0001）。根据通用标准，ACE/ID多态性似乎是先前被认为低风险人群患冠心病的一个有力危险因素。
