Department of Coronary and Structural Heart Diseases, National Institute of Cardiology, Warsaw, Poland.
Department of Medical Genetics, Medical University of Warsaw, Warsaw, Poland
Pol Arch Intern Med. 2020 Sep 30;130(9):748-756. doi: 10.20452/pamw.15461. Epub 2020 Jun 25.
The insertion/deletion (I/D) polymorphism of the angiotensin‑converting enzyme (ACE) gene is associated with younger age at coronary artery disease (CAD) onset. Some data indicate the relationship between the DD genotype and the fibrinogen level. At the same time, the regulation of the renin-angiotensin system differs in women and men.
The objective of the study was to evaluate the sex‑dependentassociation of the ACE I/D polymorphism with the plasma fibrinogen level in patients with premature CAD.
The study included 407 participants with premature CAD: 257 women not older than 55 years and 150 men not older than 45 years. Study participants had at least 1 stenosis ≥50% in a major epicardial coronary artery. The ACE I/D polymorphism (rs4343) was genotyped using polymerase chain reaction. Fibrinogen levels were measured with a modified Clauss method. We found a significant interaction indicating that sex modifies the influence of the I/D polymorphism of the ACE gene on fibrinogen levels (P = 0.02). The highest mean fibrinogen level, adjusted for age and smoking status, was observed in women with the DD genotype (575.7 mg/dl) and it was significantly higher than in men with the DD genotype (367.1 mg/dl; P <0.001) or in women with the ID genotype (491.7 mg/dl; P = 0.04). In men, there was no significant difference in mean adjusted fibrinogen levels across genotypes.
The DD genotype of the ACE gene was associated with higher plasma fibrinogen levels in women with premature CAD yet not in men.
血管紧张素转换酶（ACE）基因的插入/缺失（I/D）多态性与冠状动脉疾病（CAD）发病年龄较轻有关。一些数据表明 DD 基因型与纤维蛋白原水平之间存在关系。同时，肾素-血管紧张素系统在女性和男性中的调节方式不同。
本研究旨在评估 ACE I/D 多态性与早发 CAD 患者血浆纤维蛋白原水平之间的性别依赖性关系。
本研究纳入了 407 例早发 CAD 患者：257 名年龄不超过 55 岁的女性和 150 名年龄不超过 45 岁的男性。研究参与者至少有 1 条主要心外膜冠状动脉的狭窄≥50%。使用聚合酶链反应对 ACE I/D 多态性（rs4343）进行基因分型。使用改良 Clauss 法测量纤维蛋白原水平。我们发现了一个显著的交互作用，表明性别改变了 ACE 基因 I/D 多态性对纤维蛋白原水平的影响（P=0.02）。在调整年龄和吸烟状况后，DD 基因型女性的纤维蛋白原平均水平最高（575.7mg/dl），明显高于 DD 基因型男性（367.1mg/dl；P＜0.001）或 ID 基因型女性（491.7mg/dl；P=0.04）。在男性中，不同基因型之间的平均调整纤维蛋白原水平无显著差异。
ACE 基因的 DD 基因型与早发 CAD 女性的血浆纤维蛋白原水平升高相关，但与男性无关。
