Objective To explore the relationship between the apolipoprotein ApoA1-75 bp polymorphism and risk for dyslipidemia and coronary artery disease (CAD).Methods A total of 723 patients (mean age (62.4 ± 10.2) years old) admitted to Guangdong General Hospital from 2011 to 2013 were enrolled.They were subdivided into CAD group (n =444) and non-CAD (n =279) group according to the result of coronary angiography (CAG).Clinical data including the profiles of lipids,-75 bp gene polymorphisms and Gensini scores were analyzed to determine the correlation between-75 bp gene polymorphisms,lipid profile and CAD.Result Frequency of male gender,history of diabetes and smoking,TC,TG,LDL-C and ApoB level were significantly higher and HDL-C level was significantly lower in CAD group than in non-CAD group (all P ＜ 0.05).Frequency of A allele was significantly lower in CAD group than in non-CAD group (43.7％ (194/444) vs.56.6％ (158/279),P =0.003).The ApoA1-75 bp gene polymorphism was significantly correlated with CAD (P ＜ 0.005).Multivariate logistic regression analysis showed that-75 bp gene polymorphism mutation (OR =0.649,P =0.021) is an independent protective factor for coronary heart disease.Conclusion ApoA1-75 bp gene polymorphism is linked with risk of dyslipidemia and CAD.%目的 探究载脂蛋白(Apo)A1-75 bp(G/A)位点多态性与血脂谱及冠状动脉病变程度的相关性.方法 入选2011年10月到2013年10月就诊于广东省人民医院的胸痛患者723例,根据冠状动脉造影结果分为冠心病组444例和正常对照组279例,其中男472例,女251例,平均年龄(62.4±10.2)岁.比较两组间一般资料、血脂及-75 bp位点多态性,分析-75 bp位点多态性对血脂谱的影响.采用logistic多因素回归分析冠心病的危险因素,并根据Gensini评分进行分组,Gensini评分=0(n=98),0＜ Gensini评分≤30(n=223),30＜ Gensini评分≤60(n=184),Gensini评分＞60(n =218),比较各组-75 bp位点多态性的差异.结果 冠心病组中男性、吸烟和糖尿病比例、总胆固醇(rC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)水平均高于正常对照组,而高密度脂蛋白胆固醇(HDL-C)、ApoA1水平低于正常对照组(P＜0.05);冠心病组的ApoA1-75 bp位点A等位基因频率为43.7％(194/444),低于正常对照组的56.6％ (158/279) (P =0.003).在血脂谱分析中,-75 bp位点突变型(GA/AA)的HDL-C、ApoA1水平高于野生型(GG),差异有统计学意义(男:P=0.033,0.011;女:P=0.007,0.036).logistic多因素回归分析提示-75 bp位点变异是冠心病的保护因素(OR=0.649,P=0.021).随着Gensini评分的增加,A等位基因频率减少(男:P=0.012;女:P=0.006).同时,-75 bp位点突变型与冠状动脉病变严重程度相关,以Gensini评分=0为对照,0＜Gensini评分≤30、30＜Gensini评分≤60及Gensini评分＞60的OR值分别为0.541、0.446、0.331(P均＜0.05).结论 ApoA1-75 bp位点多态性与冠心病患者血脂谱和冠状动脉病变程度相关,ApoA1-75 bp位点突变型是冠心病的保护因素.
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