血管紧张素转换酶基因的DD基因型是左心室肥厚的一个危险因素。

DD genotype of the angiotensin-converting enzyme gene is a risk factor for left ventricular hypertrophy.

作者信息

Iwai N, Ohmichi N, Nakamura Y, Kinoshita M

机构信息

First Department of Internal Medicine, Shiga University of Medical Sciences, Japan.

出版信息

Circulation. 1994 Dec;90(6):2622-8. doi: 10.1161/01.cir.90.6.2622.

DOI:10.1161/01.cir.90.6.2622

PMID:7994801

Abstract

BACKGROUND

The cardiac renin-angiotensin system has been suggested to be involved in the development of left ventricular hypertrophy. In humans, a strong correlation has been found between plasma angiotensin I-converting enzyme (ACE) activity and the insertion/deletion (I/D) polymorphism of the ACE gene, which has been reported to be associated with myocardial infarction, ischemic and idiopathic dilated cardiomyopathy, sudden death in hypertrophic cardiomyopathy, and restenosis after percutaneous transluminal coronary angioplasty. In the present study, we examined the possibility that the genotype of the ACE gene might influence the development of left ventricular hypertrophy.

METHODS AND RESULTS

The study population consisted of 268 subjects randomly selected from our outpatient clinic. In 142 subjects, left ventricular mass (LVM) was determined by echocardiogram. The genotype of the ACE gene was determined by the polymerase chain reaction. ANCOVA revealed that the genotype of the ACE gene had no effect on blood pressure. The percentage of the explained variance of LVM with variables including diastolic blood pressure (DBP, P = .0001), body mass index (BMI, P = .0001), sex (P = .0009), and the genotype of the ACE gene (P = .0017) was 34.61%. Significant differences in the effects of the genotype of the ACE gene on LVM were observed between the II and DD (P = .0004) and between the ID and DD (P = .0077) genotypes. The percentage of the explained variance of the LVM/ht ratio with variables including sex (P = .134), age (P = .3655), the genotype of the ACE gene (P = .0014), BMI (P = .0001), and DBP (P = .0001) was 31.25%. Significant differences in the effects of the genotype of the ACE gene on LVM/ht were observed between the II and DD genotypes (P = .0003) and between the ID and DD genotypes (P = .0091).

CONCLUSIONS

In addition to BMI and DBP, the genotype of the ACE gene was a significant predictor of LVM and LVM/ht in our study population.

摘要

背景

心脏肾素 - 血管紧张素系统被认为与左心室肥厚的发生有关。在人类中，血浆血管紧张素I转换酶（ACE）活性与ACE基因的插入/缺失（I/D）多态性之间存在很强的相关性，据报道该多态性与心肌梗死、缺血性和特发性扩张型心肌病、肥厚型心肌病猝死以及经皮腔内冠状动脉成形术后再狭窄有关。在本研究中，我们探讨了ACE基因的基因型可能影响左心室肥厚发生的可能性。

方法与结果

研究人群包括从我们门诊随机选取的268名受试者。在142名受试者中，通过超声心动图测定左心室质量（LVM）。通过聚合酶链反应确定ACE基因的基因型。协方差分析显示，ACE基因的基因型对血压没有影响。包括舒张压（DBP，P = 0.0001）、体重指数（BMI，P = 0.0001）、性别（P = 0.0009）和ACE基因的基因型（P = 0.0017）等变量对LVM的解释方差百分比为34.61%。在II型和DD型（P = 0.0004）以及ID型和DD型（P = 0.0077）基因型之间，观察到ACE基因的基因型对LVM的影响存在显著差异。包括性别（P = 0.134）、年龄（P = 0.3655）、ACE基因的基因型（P = 0.0014）、BMI（P = 0.0001）和DBP（P = 0.0001）等变量对LVM/ht比值的解释方差百分比为31.25%。在II型和DD型基因型之间（P = 0.0003）以及ID型和DD型基因型之间（P = 0.0091），观察到ACE基因的基因型对LVM/ht的影响存在显著差异。