Tosic Dragovic J, Popovic J, Djuric P, Jankovic A, Bulatovic A, Barovic M, Pravica V, Marinkovic J, Dimkovic N
a Clinical Department for Renal Diseases, Zvezdara University Medical Center, Dimitrija Tucovica 161, 11000 Belgrade, Serbia.
b Medical Faculty, Belgrade University, Dr Subotica 9, 11000 Belgrade, Serbia.
Can J Physiol Pharmacol. 2016 Oct;94(10):1106-1109. doi: 10.1139/cjpp-2015-0569. Epub 2016 Aug 7.
Uremia-related inflammation is prone to be a key factor to explain high cardiovascular morbidity in hemodialysis patients. Genetic susceptibility may be of importance, including IL-10, IL-6, and TNF. The aim was to analyze IL-10, IL-6, and TNF gene polymorphisms in a group of hemodialysis patients and to correlate the findings with cardiovascular morbidity. This study included 169 patients on regular hemodialysis at Zvezdara University Medical Center. Gene polymorphisms for IL-10, IL-6 and TNF were determined using PCR. These findings were correlated with the cardiovascular morbidity data from patient histories. Heterozygots for IL-10 gene showed significantly lower incidence of cardiovascular events (p = 0.05) and twice lower risk for development of myocardial infarction, but experienced twice higher risk for left ventricular hypertrophy. Regarding TNF gene polymorphism, patients with A allele had 1.5-fold higher risk for cerebrovascular accident and cardiovascular events and 2-fold higher risk for hypertension and peripheral vascular disease. Patients with G allele of IL-6 gene experienced 1.5-fold higher risks for cerebrovascular accident. We need studies with larger number of patients for definitive conclusion about the influence of gene polymorphisms on cardiovascular morbidity in hemodialysis patients and its importance in everyday clinical practice.
尿毒症相关炎症很可能是解释血液透析患者心血管疾病高发病率的关键因素。遗传易感性可能很重要，包括白细胞介素-10（IL-10）、白细胞介素-6（IL-6）和肿瘤坏死因子（TNF）。目的是分析一组血液透析患者中IL-10、IL-6和TNF基因多态性，并将结果与心血管疾病发病率相关联。本研究纳入了兹韦兹达拉大学医学中心169例定期进行血液透析的患者。采用聚合酶链反应（PCR）测定IL-10、IL-6和TNF的基因多态性。这些结果与患者病史中的心血管疾病发病率数据相关联。IL-10基因杂合子的心血管事件发生率显著较低（p = 0.05），发生心肌梗死的风险低两倍，但发生左心室肥厚的风险高两倍。关于TNF基因多态性，携带A等位基因的患者发生脑血管意外和心血管事件的风险高1.5倍，患高血压和外周血管疾病的风险高2倍。携带IL-6基因G等位基因的患者发生脑血管意外的风险高1.5倍。我们需要开展纳入更多患者的研究，以明确基因多态性对血液透析患者心血管疾病发病率的影响及其在日常临床实践中的重要性。
