Tangurek Burak, Ozer Nihat, Sayar Nurten, Terzi Sait, Yilmaz Hale, Dayi Sennur Unal, Ciloglu Figen, Aksu Huseyin, Asilturk Recep, Cagil Aydin
Cardiology Department, Siyami Ersek Cardiovascular and Thoracic Surgery Center, Istanbul, Turkey.
Heart Vessels. 2006 Sep;21(5):285-90. doi: 10.1007/s00380-005-0902-0. Epub 2006 Sep 29.
Previous studies revealed that there were various mutations on endothelial nitric oxide synthase (eNOS) gene and these mutations might be a risk factor for coronary artery disease (CAD), myocardial infarction (MI), and hypertension (HT). In this study, we aimed to investigate the relationship between eNOS gene polymorphism (T-786 C) and coronary artery disease in the Turkish population. Two hundred and eleven unrelated individuals (152 male, 59 female, mean age 59 years, range 27-85) whose angiographic examinations were performed in our hospital were enrolled into the study; 159 of these had angiographically determined coronary artery lesions (>or=50% stenosis at least in one vessel). Fifty-two individuals were free of coronary artery disease on their coronary angiography. The Gensini scoring system was used to determine the severity of the CAD. The polymerase chain reaction (PCR) method was used for genotyping the individuals. To determine the independent risk factors for coronary artery disease, multivariate logistic regression analysis was used. The variant distribution of the T-786 C polymorphism was as follows. For all individuals: TT 94 (44.5%), TC 88 (41.7%), CC 29 (13.8%); in CAD patients: TT 63 (39.6%), TC 73 (45.9%), CC 23 (14.5%); and in normal individuals: TT 31 (59.6%), TC 15 (28.8%), CC 6 (11.5%). There was a statistically significant difference in the variant distribution between CAD and normal individuals (P<0.05). On the other hand, when we compared the frequency of the at-least-one-C-allele carriers (CC+TC, dominant model) and TT homozygous, those with at least one C allele were more prevalent in CAD patients. The results were as follows. In coronary artery disease patients: CC+TC 96 (60.4%), TT 63 (39.6%); in normals: TC+CC 21 (40.4%), TT 31 (59.6%) (P<0.01). When we compared the allele distribution (T vs C, additive model) between CAD patients and normal controls, the results were as follows: T 0.625 vs 0.740, C 0.375 vs 0.260; there was also a statistically significant association between CAD and C allele (P<0.05). When we compared the means of the Gensini scores between each genotype of the T-786 C mutation, there was a statistically significant difference. The results were TT (48.6+/-37.3, median 43.0), TC (55.4+/-41.2, median 41.0), CC (77+/-43.6, median 80.0) (P<0.05). Multivariate logistic regression analysis revealed that C-dominant (CC+TC) individuals had 2.9-fold more likelihood to suffer from CAD (odds ratio: 2.902; confidence interval: 1.272-6.622) (P<0.05). We conclude that the T-786 C polymorphism of eNOS gene might be a risk factor for coronary artery disease in the Turkish population.
先前的研究表明,内皮型一氧化氮合酶(eNOS)基因存在多种突变,这些突变可能是冠状动脉疾病(CAD)、心肌梗死(MI)和高血压(HT)的危险因素。在本研究中,我们旨在调查土耳其人群中eNOS基因多态性(T-786 C)与冠状动脉疾病之间的关系。本研究纳入了我院进行血管造影检查的211名无亲属关系的个体(152名男性,59名女性,平均年龄59岁,范围27-85岁);其中159人经血管造影确定存在冠状动脉病变(至少一支血管狭窄≥50%)。52人冠状动脉造影显示无冠状动脉疾病。采用Gensini评分系统确定CAD的严重程度。采用聚合酶链反应(PCR)方法对个体进行基因分型。为了确定冠状动脉疾病的独立危险因素,采用多因素逻辑回归分析。T-786 C多态性的变异分布如下。所有个体:TT 94例(44.5%),TC 88例(41.7%),CC 29例(13.8%);CAD患者:TT 63例(39.6%),TC 73例(45.9%),CC 23例(14.5%);正常个体:TT 31例(59.6%),TC 15例(28.8%),CC 6例(11.5%)。CAD患者与正常个体的变异分布存在统计学显著差异(P<0.05)。另一方面,当我们比较至少携带一个C等位基因的携带者(CC+TC,显性模型)和TT纯合子的频率时,至少携带一个C等位基因的个体在CAD患者中更为普遍。结果如下。冠状动脉疾病患者:CC+TC 96例(60.4%),TT 63例(39.6%);正常个体:TC+CC 21例(40.4%),TT 31例(59.6%)(P<0.01)。当我们比较CAD患者与正常对照之间的等位基因分布(T与C,加性模型)时,结果如下:T 0.625对0.740,C 0.375对0.260;CAD与C等位基因之间也存在统计学显著关联(P<0.05)。当我们比较T-786 C突变各基因型之间的Gensini评分均值时,存在统计学显著差异。结果为TT(48.6±37.3,中位数43.0),TC(55.4±41.2,中位数41.),CC(77±43.6,中位数80.0)(P<0.05)。多因素逻辑回归分析显示,C显性(CC+TC)个体患CAD的可能性高其2.9倍(比值比:2.902;置信区间:(1.2)72-6.622)(P<0.05)。我们得出结论,eNOS基因的T-786 C多态性可能是土耳其人群冠状动脉疾病的一个危险因素。