对氧磷酶基因多态性及血浆同型半胱氨酸硫内酯复合物水平与冠心病的关系

目的探讨对氧磷酶(PON)基因多态性(PON1 T-107C、PON2 C311S)及血浆同型半胱氨酸(Hcy)、同型半胱氨酸硫内酯(HTL)复合物水平与冠心病发病的关系。方法对203例经冠状动脉造影证实为冠心病的患者及117例经冠状动脉造影证实无冠状动脉病变的对照者进行研究,采用竞争性 ELISA 法测定血浆 HTL 复合物水平;采用高压液相色谱法测定血浆 Hcy 的水平;采用多聚酶链反应-限制性内切酶片段长度多态性(PCR-RFLP)分析 PON 基因中 PON1 T-107C 和 PON2 C311S基因多态性。结果冠心病组血浆 Hcy 和 HTL 复合物水平明显高于对照组(P<0.01);PON1 T-107C 基因型与等位基因频率分布在冠心病组与对照组间比较差异无统计学意义(P>0.05);而PON2 C311S 的 SS 基因型分布在冠心病组低于对照组(P<0.05),但等位基因频率分布两组间差异无统计学意义(P>0.05);当两位点的等位基因 T、S 同时出现时(即 CT/TF+CS/SS 基因型)血浆 Hcy及 HTL 复合物水平较 CC+CS/CC 或 CT+CC 基因型明显降低Hcy(11.83±4.76)μmol/L 与(15.32±10.32)μmol/L;HTL(24.36±9.30)U/ml 与(32.05±10.44)U/ml],差异有统计学意义(P<0.05)。冠心病合并2型糖尿病组与冠心病无糖尿病组及对照组相比,PON2基因型分布差异有统计学意义,冠心病合并2型糖尿病患者中 C 等位基因频率明显增高(P<0.05)。结论血浆 Hcy 和 HTL 复合物水平升高可能是冠心病发病的独立危险因素,PON1 T 等位基因和 PON2 S 等位基因同时出现可能在动脉粥样硬化形成过程中起到保护作用,而 PON2 C311S 多态性的 C 等位基因存在可能与冠心病患者合并2型糖尿病的几率增高相关。

Association of paraoxonase polymorphisms and serum homocysteine thiolactone complex with coronary heart disease

OBJECTIVE: To investigate the relationship between paraoxonase (PON) polymorphisms and serum homocysteine thiolactone (HTL) and coronary heart diseases. METHOD: In this prospective study, serum complex of HTL levels using ELISA, and the lever of serum Hcy using high pressure liquid chromatography (HPLC), determined the PON1/T(-107)C and PON2/C311S genotypes using PCR-restriction fragment length polymorphisms 203 were measured in patients with angiographic documented coronary heart disease (CAD) and 117 controls. RESULTS: Serum levels of Hcy and the complex of HTL in CAD patients were significantly higher than that in controls (P < 0.05). No significant difference was found in frequencies of PON1/T(-107)C genotypes and alleles (P > 0.05) between CAD patient and controls. The PON2/C311S (SS) genotype was lower in CAD patients than that in controls (P < 0.05), while the frequency of allele was similar between the two groups (P > 0.05). The T allele of PON1/T(-107)C and S alleles of PON2/C311S polymorphism were associated with lower plasma Hcy and HTL complex Hcy (11.83 +/- 4.76) micromol/L vs (15.32 +/- 10.32) micromol/L, P < 0.05; HTL complex (24.36 +/- 9.30) U/ml vs (32.05 +/- 10.44) U/ml, P < 0.05]. The genetype PON2 and allele C were higher in CAD patients with type 2 diabetes than that in CAD patients without type 2 diabetes and controls (P < 0.005). CONCLUSIONS: The elevation of serum Hcy and the complex of HTL were associated with increased risk of coronary heart disease. The allele PON1/(-107)T and PON2/311S might be protective for the development of atherosclerosis.