Sousa Ana Célia, Mendonça Maria I, Pereira Andreia, Gouveia Sara, Freitas Ana I, Guerra Graça, Rodrigues Mariana, Henriques Eva, Freitas Sónia, Borges Sofia, Pereira Décio, Brehm António, Palma Dos Reis Roberto
1 Unidade de Investigação, Hospital Doutor Nélio Mendonça , Funchal, Portugal .
2 Laboratório de Genética Humana, Universidade da Madeira , Funchal, Portugal .
Genet Test Mol Biomarkers. 2017 Oct;21(10):625-631. doi: 10.1089/gtmb.2017.0048. Epub 2017 Sep 5.
Essential hypertension (EH) is a disease in which both environment and genes have an important role. This study was designed to identify the interaction model between genetic variants and environmental risk factors that most highly potentiates EH development.
We performed a case-control study with 1641 participants (mean age 50.6 ± 8.1 years), specifically 848 patients with EH and 793 controls, adjusted for gender and age. Traditional risk factors, biochemical and genetic parameters, including the genotypic discrimination of 14 genetic variants previously associated with EH, were investigated. Multifactorial dimensionality reduction (MDR) software was used to analyze gene-environment interactions. Validation was performed using logistic regression analysis with environmental risk factors, significant genetic variants, and the best MDR model.
The best model indicates that the interactions among the ADD1 rs4961 640T allele, diabetes, and obesity (body mass index ≥30) increase approximately four-fold the risk of EH (odds ratio = 3.725; 95% confidence interval: 2.945-4.711; p < 0.0001).
This work showed that the interaction between the ADD1 rs4961 variant, obesity, and the presence of diabetes increased the susceptibility to EH four-fold. In these circumstances, lifestyle adjustment and diabetes control should be intensified in patients who carry the ADD1 variant.
原发性高血压(EH)是一种环境和基因都起重要作用的疾病。本研究旨在确定最能增强EH发生的遗传变异与环境风险因素之间的相互作用模型。
我们对1641名参与者(平均年龄50.6±8.1岁)进行了病例对照研究,具体为848例EH患者和793名对照,对性别和年龄进行了校正。研究了传统风险因素、生化和遗传参数,包括对先前与EH相关的14种遗传变异的基因分型鉴别。使用多因素降维(MDR)软件分析基因-环境相互作用。使用环境风险因素、显著遗传变异和最佳MDR模型进行逻辑回归分析以进行验证。
最佳模型表明,ADD1 rs4961 640T等位基因、糖尿病和肥胖(体重指数≥30)之间的相互作用使EH风险增加约四倍(比值比=3.725;95%置信区间:2.945-4.711;p<0.0001)。
这项研究表明,ADD1 rs4961变异、肥胖和糖尿病之间的相互作用使EH易感性增加了四倍。在这些情况下,应加强携带ADD1变异患者的生活方式调整和糖尿病控制。