血管收縮素元與血管收縮素轉化基因預測冠狀動脈心臟病的加成作用

Abstract

Angiotensinogen (AGT) and angiotensin-converting enzyme (ACE) gene polymorphisms have been implicated in the pathogenesis of coronary artery disease (CAD) and myocardial infarction (MI). However, conclusions are inconsistent and there are few combination analysis of the AGT and ACE genes in relation to CAD and MI. We therefore study 255 Taiwanese people, including 171 CAD patients and 84 non-CAD controls. A novel stepdown polymerase chain reaction (PCR) was used to genotype the ACE insertion/deletion(I/D) polymorphism and a stepdown PCRdirect sequencing to genotype the M235T and T174M variants of the AGT gene. The results showed that the 235T allele and TT genotype frequencies of the AGT gene were 82% and 65% respectively in the non-CAD group vs. 83% and 68% in the CAD group (p>0.05). The 174T allele and TT genotype frequencies were 92% and 86% in the non-CAD group vs. 89% and 80% in the CAD group (p>0.05). The D allele and DD genotype frequencies of the ACE gene were 64% and 40% respectively in the non-CAD group vs. 69% and 46% in the CAD group (p>0.05). There was no difference of AGT or ACE gene polymorphism in subjects with MI, low risk, or different severities of CAD. However, subjects with double homozygosity of 235TT/DD genotype had a higher prevalence (75%) of CAD than those with 235TT/(ID+II) (52%) or (235MT+MM)/DD (56%). The odds ratio was 2.61 (95% CI 1.88 to 3.61). Subjects with double heterozygosity of (235MT+MM)/(ID+II) also had a higher prevalence (71%) of CAD. The odds ratio was 2.14 (95% CI 1.48 to 3.09). Our data show that no association between each single gene polymorphism of the AGT and ACE and coronary heart disease can be found in the Taiwanese population. However, there is a synergistic gene effect that confers an increased risk for CAD.