Kurnik Daniel, Friedman Eitan A, Muszkat Mordechai, Sofowora Gbenga G, Xie Hong-Guang, Dupont William D, Wood Alastair J J, Stein C Michael
Departments of Medicine and Pharmacology, Division of Clinical Pharmacology bDepartment of Biomedical Statistics, Vanderbilt University School of Medicine, Nashville, TN 37232, USA.
Pharmacogenet Genomics. 2008 Sep;18(9):743-50. doi: 10.1097/FPC.0b013e3282fee5a1.
Cardiovascular responses to stressors are regulated by sympathetic activity, increased in black Americans, and associated with future cardiovascular morbidity. Our aim was to determine whether two functional variants in genes regulating sympathetic activity, a deletion in the alpha2C-adrenergic receptor (ADRA2C del322-325) and a G-protein beta3-subunit variant (GNB3 G825T), affect cardiovascular responses to physiologic stressors and contribute to their ethnic differences.
We measured heart rate and blood pressure responses to a cold pressor test (CPT) in 79 healthy participants (40 blacks, 39 whites), aged 25.7+/-5.3 years, and determined genotypes for the ADRA2C and GNB3 variants. We examined the response variables (increase in heart rate and blood pressure) in multiple linear regression analyses adjusting first for baseline measures, ethnicity, and other covariates, and then additionally for genotypes.
Black participants had a greater heart rate response to CPT than whites [mean difference, 9.9 bpm; 95% confidence interval (CI), 4.1 to 15.6; P=0.001]. Both the ADRA2C del/del (15.8 bpm; 95% CI, 8.0-23.7; P<0.001) and GNB3 T/T genotypes (6.8 bpm; 95% CI, 0.9-12.7; P=0.026) were associated with greater heart rate response. After adjusting for genotypes, the ethnic difference was abrogated (1.3 bpm; 95% CI, -5.4-8.0; P=0.70), suggesting that the genetic variants contributed substantially to ethnic differences.
Variation in genes that regulate sympathetic activity affects hemodynamic stress responses and contributes to their ethnic differences. This study elucidates how genetic factors may in part explain ethnic differences in cardiovascular regulation.
心血管对应激源的反应受交感神经活动调节,在美国黑人中增强,并与未来心血管疾病发病率相关。我们的目的是确定调节交感神经活动的基因中的两个功能性变体,即α2C - 肾上腺素能受体缺失(ADRA2C del322 - 325)和G蛋白β3亚基变体(GNB3 G825T),是否影响心血管对生理应激源的反应并导致种族差异。
我们测量了79名年龄在25.7±5.3岁的健康参与者(40名黑人,39名白人)对冷加压试验(CPT)的心率和血压反应,并确定了ADRA2C和GNB3变体的基因型。我们在多元线性回归分析中检查反应变量(心率和血压的增加),首先对基线测量、种族和其他协变量进行调整,然后再对基因型进行调整。
黑人参与者对CPT的心率反应比白人更大[平均差异,9.9次/分钟;95%置信区间(CI),4.1至15.6;P = 0.001]。ADRA2C del/del基因型(15.8次/分钟;95% CI,8.0 - 23.7;P < 0.001)和GNB3 T/T基因型(6.8次/分钟;95% CI,0.9 - 12.7;P = 0.026)均与更大的心率反应相关。在对基因型进行调整后,种族差异消失(1.3次/分钟;95% CI, - 5. .4 - 8.0;P = 0.70),表明基因变体对种族差异有很大影响。
调节交感神经活动的基因变异影响血流动力学应激反应并导致种族差异。本研究阐明了遗传因素如何部分解释心血管调节中的种族差异。