Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong.
J Nutr Health Aging. 2012 Mar;16(3):262-8. doi: 10.1007/s12603-011-0123-4.
We examined the contribution of ACE I/D polymorphism in a large Chinese population to four year change in ankle-brachial index (ABI), development of cardiovascular diseases and mortality in a prospective study adjusting for many confounding factors.
Data are drawn from a longitudinal study of 4000 community-living men and women aged 65 years and over, for which detailed information regarding lifestyle, chronic diseases, body mass index (BMI), ABI measurements and ACE polymorphisms were documented at baseline. During the fifth year of follow up, incident cardiovascular diseases, ABI, and mortality were documented, and related to ACE genotype adjusting for age, smoking, alcohol, dietary intake, physical activity, body mass index, and use of ACE inhibitors.
Women with the D/D genotype had the greatest reduction in mean ABI after adjusting for confounding factors. D/D genotype was also more common among women who developed hypertension or myocardial infarction. However D/D genotype was associated with mortality only in men.
In a Chinese elderly population, ACE polymorphism may be considered "deleterious" to longevity, the D/D genotype being associated with mortality, the atherosclerotic process, hypertension and myocardial infarction. There are gender differences in the relationship between D/D genotype and cardiovascular diseases and mortality may not be mediated by the atherosclerotic process alone.
本研究通过对一个大型中国人群进行前瞻性研究，在调整了多种混杂因素后，探讨 ACE I/D 多态性对踝臂指数（ABI）四年变化、心血管疾病发展和死亡率的影响。
本研究的数据来自一项对 4000 名 65 岁及以上社区居民的纵向研究，在基线时详细记录了生活方式、慢性疾病、体重指数（BMI）、ABI 测量值和 ACE 多态性等信息。在随访的第五年，记录了心血管疾病的发生、ABI 和死亡率，并根据 ACE 基因型，在调整年龄、吸烟、饮酒、饮食摄入、体力活动、BMI 和 ACE 抑制剂使用等因素后进行分析。
女性 D/D 基因型者在调整混杂因素后 ABI 的平均下降幅度最大。D/D 基因型在发生高血压或心肌梗死的女性中更为常见。然而，D/D 基因型仅与男性的死亡率相关。
在中国老年人群中，ACE 多态性可能被认为对长寿有害，D/D 基因型与死亡率、动脉粥样硬化过程、高血压和心肌梗死有关。D/D 基因型与心血管疾病和死亡率之间的关系存在性别差异，死亡率可能不仅仅通过动脉粥样硬化过程来介导。
