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血小板糖蛋白PlA和纤维蛋白原T/G+1689多态性与外周动脉疾病和缺血性心脏病的关系。

Relationship of the platelet glycoprotein PlA and fibrinogen T/G+1689 polymorphisms with peripheral arterial disease and ischaemic heart disease.

作者信息

Smith Felicity B, Connor J Michael, Lee Amanda J, Cooke Alexander, Lowe Gordon D O, Rumley Ann, Fowkes F Gerald

机构信息

Wolfson Unit for Prevention of Peripheral Vascular Diseases, Department of Community Health Sciences, University of Edinburgh Medical School, Teviot Place, Edinburgh EH8 9AG, UK.

出版信息

Thromb Res. 2003;112(4):209-16. doi: 10.1016/j.thromres.2003.11.010.

Abstract

INTRODUCTION

Genetic variation in plasma fibrinogen and the platelet receptor GP IIIa locus has been independently associated with increased risks of ischaemic heart disease, but there have been few reports on the relationship with peripheral arterial disease. This study determined the risk of peripheral arterial disease and ischaemic heart disease associated with polymorphisms of fibrinogen T/G(+1689) and platelet glycoprotein Pl(A) genes and the effects of cigarette smoking and fibrinogen.

MATERIALS AND METHODS

In the 5-year follow-up phase of the Edinburgh Artery Study, 939 subjects (60-79 years) had DNA extracted from a venous blood sample. One hundred sixteen subjects were identified as having angina, 87 a myocardial infarction, 104 had intermittent claudication and 663 subjects comprised a healthy group.

RESULTS

Distribution of the fibrinogen genotype was similar across the disease and healthy groups. Logistic regression analyses found no significant association between fibrinogen genotype and ischaemic heart disease and peripheral arterial disease. A lower percentage of claudicants had the Pl(A2) allele (8.3% vs. 15.2%, p=0.025). After adjustment for age and sex, the risk of IC associated with the Pl(A2) was half that of the homozygous Pl(A1) genotype (OR 0.49, 95% CI 0.25, 0.88; p<==0.05). Adjustment for lifetime smoking and fibrinogen levels increased the odds slightly to nonsignificance.

CONCLUSIONS

The Pl(A2) genotype was associated with a decreased risk of developing IC. There was no significant relationship between fibrinogen T/G(+1689) genotype and ischaemic and peripheral heart disease in this older population.

摘要

引言

血浆纤维蛋白原的基因变异和血小板受体糖蛋白IIIa位点已分别与缺血性心脏病风险增加相关,但关于其与外周动脉疾病关系的报道较少。本研究确定了与纤维蛋白原T/G(+1689)多态性和血小板糖蛋白Pl(A)基因相关的外周动脉疾病和缺血性心脏病风险,以及吸烟和纤维蛋白原的影响。

材料与方法

在爱丁堡动脉研究的5年随访阶段,从939名60 - 79岁受试者的静脉血样本中提取DNA。116名受试者被确定患有心绞痛,87名患有心肌梗死,104名有间歇性跛行,663名受试者组成健康组。

结果

疾病组和健康组的纤维蛋白原基因型分布相似。逻辑回归分析发现纤维蛋白原基因型与缺血性心脏病和外周动脉疾病之间无显著关联。跛行者中携带Pl(A2)等位基因的比例较低(8.3%对15.2%,p = 0.025)。在调整年龄和性别后,与Pl(A2)相关的间歇性跛行风险是纯合Pl(A1)基因型的一半(比值比0.49,95%可信区间0.25,0.88;p <= 0.05)。对终生吸烟和纤维蛋白原水平进行调整后,比值略有增加但无统计学意义。

结论

Pl(A2)基因型与发生间歇性跛行的风险降低相关。在这个老年人群中,纤维蛋白原T/G(+1689)基因型与缺血性和外周性心脏病之间无显著关系。

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