ICAM-1 基因 K469E 多态性与 ACS 复发及心血管死亡率的关系。

Relation between K469E gene polymorphism of ICAM-1 and recurrence of ACS and cardiovascular mortality.

机构信息

Department of Cardiology, People's Hospital of Zhengzhou, No. 33, Huanghe Road, Henan Province 450003, China.

出版信息

Asian Pac J Trop Med. 2013 Nov;6(11):916-20. doi: 10.1016/S1995-7645(13)60164-9.

DOI:10.1016/S1995-7645(13)60164-9

PMID:24083591

Abstract

OBJECTIVE

To explore the relation between K469E gene polymorphism of intercellular adhesion molecular-1 (ICAM-1) and the recurrence of ACS and cardiovascular mortality.

METHODS

A total of 185 patients with ACS hospitalized in Department of Cardiology in our hospital from Sep 2007 to Sep 2008 were selected as objectives. Polymerase chain reaction was used to analyze K469E gene polymorphism of ICAM-1. According to the genotypes, they were divided into two groups: group with K allele (KK+KE) and group without K allele (EE). The two groups were followed up prospectively for five years and blood lipid, blood pressure, blood glucose, recurrence and death of ACS were collected when the patients left hospital. The relation between ICAM-1 gene polymorphism and the recurrence of ACS and cardiovascular mortality was analyzed by Logistic regression.

RESULTS

After long-term follow-up, it was found that ACS recurred on 71 cases (38.4%) and 10 cases died, among which 3 cases died of cardiovascular disease. The recurrence of ACS and cardiovascular mortality in group with K allele were remarkably higher than that in group without K allele (P<0.01). After multivariate Logistic regression adjusted ages, gender, weight indexes, TC, LDL-C, TG, smoking, drinking, family history of cardiovascular disease, history of hypertension and the severity of coronary artery disease, the risks of ACS recurrence and cardiovascular mortality in group with genotype KK+KE was 3.31 and 3.53 times of those in group with genotype EE respectively (P<0.01). When the independent variable of hypertension was introduced in regression analysis, the risks of ACS recurrence and cardiovascular mortality in group with K allele both decreased (P<0.05). When the independent variable of HDL-C was introduced, different genotypes of ICAM-1 weren't relevant with ACS recurrence and cardiovascular mortality (P>0.05).

CONCLUSIONS

K469E gene polymorphism of ICAM-1 was related to ACS recurrence and cardiovascular mortality, K allele probably an independent risky factor and hypertension and to which the level of HDL-C were closely related.

摘要

目的

探讨细胞间黏附分子-1（ICAM-1）K469E 基因多态性与 ACS 复发和心血管死亡率的关系。

方法

选择 2007 年 9 月至 2008 年 9 月我院心内科收治的 185 例 ACS 患者为研究对象，采用聚合酶链反应分析 ICAM-1 的 K469E 基因多态性，根据基因型分为 K 等位基因组（KK+KE）和非 K 等位基因组（EE），两组患者出院后进行前瞻性随访 5 年，收集患者血脂、血压、血糖、ACS 复发及死亡情况。采用 Logistic 回归分析 ICAM-1 基因多态性与 ACS 复发及心血管死亡率的关系。

结果

长期随访发现，71 例（38.4%）ACS 复发，10 例死亡，其中 3 例死于心血管疾病。K 等位基因组 ACS 复发和心血管死亡率明显高于非 K 等位基因组（P<0.01）。多因素 Logistic 回归校正年龄、性别、体重指数、TC、LDL-C、TG、吸烟、饮酒、心血管疾病家族史、高血压病史及冠状动脉病变严重程度后，基因型 KK+KE 组 ACS 复发和心血管死亡率的风险分别是基因型 EE 组的 3.31 倍和 3.53 倍（P<0.01）。在回归分析中引入高血压的自变量时，K 等位基因组 ACS 复发和心血管死亡率的风险均降低（P<0.05）。当引入 HDL-C 的自变量时，ICAM-1 的不同基因型与 ACS 复发和心血管死亡率无关（P>0.05）。