Relationship between angiotensin-converting enzyme gene insertion/deletion polymorphisms and left ventricular hypertrophy in Uygur patients with hypertension and obstructive sleep apnea hypopnea syndrome

doi:10.3877/cma.j.issn.2095-655X.2018.04.005

Abstract

Abstract:

Objective

To explore the association of angiotensin converting enzyme(ACE) gene insertion/deletion (I/D) polymorphism with left ventricular hypertrophy in Uygur hypertension-OSAHS patients.

Methods

Seventy-two Uygur hypertension-OSAHS patients without taking ACEI/ARB antihypertensive drugs and newly diagnosed of hypertension in the First Affiliated Hospital of Xinjiang Medical University between January 2015 and December 2016 were selected. All patients underwent polymorphic sleep monitoring, 24 h ambulatory blood pressure monitoring, echocardiography, and PCR, agarose gel electrophoresis were applied to determine genotype and allele frequency of ACE gene.To group by computing left ventricular mass index, the differences of genotype and gene frequency were used and the riskfactors for left ventricular hypertrophy were analysed via Logistic regression.

Results

In hypertension-OSAHS patients, the frequencies of II, ID, DD genotypes were 37.50%, 20.83%, 41.67%, respectively, and I, D allele frequencies were 48.00%, 52.00% in LVH group. In NLVH group, the frequencies of II, ID, DD genotypes were 47.92%, 37.50%, 14.58%, respectively, and I, D allele frequencies were 67.00%, 33.00%. There were significant differences in ACE gene polymorphisms between LVH group and NLVH group in hypertension-OSAHS patients(χ²=6.75, 4.70, all P<0.05). Logistic regression analysis showed that apnea hypopnea index (AHI)(OR=6.20, 95%CI: 1.44-26.77, P<0.05), DD genotype(OR=4.61, 95%CI: 1.05-20.31, P<0.05)were the independent risk factors for LVH in Uygur hypertension-OSAHS patients.

Conclusions

The ACE I/D polymorphisms are associated with the development of left ventricular hypertrophy in Uyghur hypertension-OSAHS patients and the DD genotype Uygur patients are more likely to have left ventricular hypertrophy.

Key words: Angiotensin converting enzyme gene, Hypertrophy, left ventricular, Hypertension, Sleep apnea, obstructive, Polymorphism, single nucleotide

Xiaojing Sun, Maitikuerban Bumairemu, Yulan Chen, Simayi Zhulepiya, Xinjuan Xu, Junshi Zhang, Xiangyang Zhang. Relationship between angiotensin-converting enzyme gene insertion/deletion polymorphisms and left ventricular hypertrophy in Uygur patients with hypertension and obstructive sleep apnea hypopnea syndrome[J]. Chinese Journal of Diagnostics(Electronic Edition), 2018, 06(04): 236-241.

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References 21

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项目	LVH组(n＝24)	NLVH组(n＝48)	统计值	P值
性别(例，男/女)	13/11	33/15	χ²＝1.48	0.23
年龄(岁，±s)	52.33±6.18	50.02±9.27	t＝3.03	0.09
吸烟(例，有/无)	10/14	19/29	χ²＝0.03	0.87
饮酒(例，有/无)	8/16	21/27	χ²＝0.72	0.40
家族史(例，有/无)	19/5	39/9	χ²＝0.04	0.83
BMI[kg/m²，M(P₂₅，P₇₅)]	29.37(26.93，31.85)	28.70(26.70，31.08)	Z＝0.25	0.62
甘油三酯[mmol/L，M(P₂₅，P₇₅)]	1.52(1.26，2.14)	1.58(1.06，2.34)	Z＝0.01	0.93
总胆固醇[mmol/L，M(P₂₅，P₇₅)]	4.56(3.29，5.03)	4.02(3.32，4.91)	Z＝0.47	0.49
HDL-C(mmol/L，±s)	1.03±0.23	1.00±0.28	t＝0.98	0.33
LDL-C(mmol/L，±s)	2.84±0.95	2.76±0.84	t＝0.12	0.73
24 h SBP(mmHg，±s)	137.54±16.18	133.73±14.75	t＝0.80	0.37
24 h DBP(mmHg，±s)	80.33±8.64	81.69±10.61	t＝0.49	0.49
AHI[M(P₂₅，P₇₅)]	25.37(16.38，34.52)	20.70(8.50，34.19)	Z＝1.60	0.21

项目	LVH组(n＝24)	NLVH组(n＝48)	统计值	P值
性别(例，男/女)	13/11	33/15	χ²＝1.48	0.23
年龄(岁，±s)	52.33±6.18	50.02±9.27	t＝3.03	0.09
吸烟(例，有/无)	10/14	19/29	χ²＝0.03	0.87
饮酒(例，有/无)	8/16	21/27	χ²＝0.72	0.40
家族史(例，有/无)	19/5	39/9	χ²＝0.04	0.83
BMI[kg/m²，M(P₂₅，P₇₅)]	29.37(26.93，31.85)	28.70(26.70，31.08)	Z＝0.25	0.62
甘油三酯[mmol/L，M(P₂₅，P₇₅)]	1.52(1.26，2.14)	1.58(1.06，2.34)	Z＝0.01	0.93
总胆固醇[mmol/L，M(P₂₅，P₇₅)]	4.56(3.29，5.03)	4.02(3.32，4.91)	Z＝0.47	0.49
HDL-C(mmol/L，±s)	1.03±0.23	1.00±0.28	t＝0.98	0.33
LDL-C(mmol/L，±s)	2.84±0.95	2.76±0.84	t＝0.12	0.73
24 h SBP(mmHg，±s)	137.54±16.18	133.73±14.75	t＝0.80	0.37
24 h DBP(mmHg，±s)	80.33±8.64	81.69±10.61	t＝0.49	0.49
AHI[M(P₂₅，P₇₅)]	25.37(16.38，34.52)	20.70(8.50，34.19)	Z＝1.60	0.21

组别	例数	基因型			等位基因
组别	例数	II	ID	DD	I	D
LVH组	24	9(37.50)	5(20.83)	10(41.67)	23(48.00)	25(52.00)
NLVH组	48	23(47.92)	18(37.50)	7(14.58)	64(67.00)	32(33.00)
χ²值	?	6.75	?	4.70	?	?
P值	?	0.03	?	0.03	?	?

组别	例数	基因型			等位基因
组别	例数	II	ID	DD	I	D
LVH组	24	9(37.50)	5(20.83)	10(41.67)	23(48.00)	25(52.00)
NLVH组	48	23(47.92)	18(37.50)	7(14.58)	64(67.00)	32(33.00)
χ²值	?	6.75	?	4.70	?	?
P值	?	0.03	?	0.03	?	?

影响因素	B	SE	P值	OR值	OR(95%CI)
女性	1.50	0.95	0.12	4.46	0.69～28.86
吸烟	0.85	0.92	0.36	2.33	0.38～14.21
饮酒	0.40	0.86	0.64	1.49	0.28～8.02
家族史	0.20	0.74	0.78	1.23	0.29～5.19
BMI	－0.60	0.67	0.37	0.55	0.15～2.04
甘油三酯	0.47	0.72	0.51	1.61	0.40～6.53
总胆固醇	－2.63	1.66	0.11	0.07	0.00～1.87
HDL－C	－0.43	0.76	0.57	0.65	0.15～2.88
LDL－C	0.91	0.64	0.15	2.49	0.72～8.70
AHI	1.83	0.75	0.01	6.20	1.44～26.77
基因型ID vs II	0.08	0.78	0.92	1.07	0.24～5.03
基因型DD vs II	1.53	0.76	0.04	4.61	1.05～20.31

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