Xia Kun, Ding Rongjing, Zhang Zhiyong, Li Weiming, Shang Xiaoming, Yang Xinchun, Wang Lefeng, Zhang Qi
Heart Center, Beijing Chao Yang Hospital, Capital Medical University, Beijing, China.
Department of Cardiology, Peking University People's Hospital, Beijing, China.
Gene. 2017 Aug 15;624:43-49. doi: 10.1016/j.gene.2017.04.045. Epub 2017 Apr 27.
Adrenergic receptors play a key role in activating the sympathetic nervous system, which often accompanies with the development of myocardial infarction (MI). Here, we aimed to test the association of eight potentially functional polymorphisms in five adrenergic receptor-encoding genes with MI risk. Genotypes were available for 717 MI patients and 612 controls. There were no detectable deviations from the Hardy-Weinberg equilibrium for all study polymorphisms. Allele frequencies differed remarkably for ADRA2B D/I (P<0.001), ADRB1 Ser49Gly (P=0.002), ADRB2 Gln27Glu (P=0.005), and ADRB3 Trp64Arg (P<0.001) polymorphisms, even after the Bonferroni correction. Systolic blood pressure was significantly lower in ADRA2B II genotype carriers than in the DD genotype carriers (P=0.006), while plasma high-density lipoprotein cholesterol was significantly higher in patients carrying ADRA2B I allele and ADRB1 49Ser allele than in patients with the DD genotype and 49Gly/49Gly genotype, respectively (P=0.018 and 0.033). Overall best interaction model consisted of ADRA2B D/I, ADRB1 Ser49Gly, dyslipidemia and hypertension, with the highest testing accuracy of 0.627 and the maximal 10-fold cross-validation consistency (P=0.017). Finally, a nomogram was depicted based on four significant polymorphisms and metabolic risk factors, and it had a better predictive utility and was internally validated with a discrimination C-index of 0.723 (P<0.001). Altogether, we identified two polymorphisms, ADRA2B D/I and ADRB1 Ser49Arg, which not only altered genetic susceptibility to MI, but also impacted on blood pressure and plasma lipid changes, and their combination with metabolic risk factors constituted the overall best interaction model.
肾上腺素能受体在激活交感神经系统中起关键作用,而交感神经系统的激活常伴随心肌梗死(MI)的发生。在此,我们旨在测试五个肾上腺素能受体编码基因中的八个潜在功能性多态性与MI风险的关联。有717例MI患者和612例对照的基因型数据。所有研究多态性均未检测到偏离哈迪-温伯格平衡的情况。即使经过邦费罗尼校正,ADRA2B D/I(P<0.001)、ADRB1 Ser49Gly(P=0.002)、ADRB2 Gln27Glu(P=0.005)和ADRB3 Trp64Arg(P<0.001)多态性的等位基因频率仍有显著差异。ADRA2B II基因型携带者的收缩压显著低于DD基因型携带者(P=0.006),而携带ADRA2B I等位基因和ADRB1 49Ser等位基因的患者的血浆高密度脂蛋白胆固醇分别显著高于DD基因型和49Gly/49Gly基因型的患者(P=0.018和0.033)。总体最佳交互模型由ADRA2B D/I、ADRB1 Ser49Gly、血脂异常和高血压组成,测试准确性最高为0.627,最大10倍交叉验证一致性为(P=0.017)。最后,基于四个显著多态性和代谢危险因素绘制了列线图,其具有更好的预测效用,内部验证的判别C指数为0.723(P<0.001)。总之,我们鉴定出两个多态性,即ADRA2B D/I和ADRB1 Ser49Arg,它们不仅改变了MI的遗传易感性,还影响血压和血脂变化,并且它们与代谢危险因素的组合构成了总体最佳交互模型。