| Objective:Lipid metabolic disorder is the most important risk factor for atherosclerosis (AS).So far there are a lot of evidence certificate that the scavenger receptor sCD36is related with the metabolism of LDL-c, sCD36also involved in The metabolic process of free fatty acids, triglycerides and other lipidmetabolism, which are all known as risk factors of coronary heart disease. The purpose of this study is to explore the associate between serum sCD36levels and coronary artery lesions, and then research the relationship between sCD36gene rs1049673polymorphism and coronary heart disease for premature severe three-vessel coronary artery lesions at the gene level.Methods:Totally consecutive164cases of hospitalized patients were collected at the Second Hospital of Tianjin Medical University during October2009to August2011. All cases accepted coronary angiography.77cases were male, and58cases were female. The objects were divided into the disease group (early-onset of three-vessel coronary artery lesions) of79cases and normal control group of56cases according to age and the result of coronary angiography. Inclusion criteria:Premature severe there-vessel coronary aetery lesions group.the onset age of CHD for male is less than55years old and for female less than65years old; severe three-vessel coronary artery lesions indicates the area stenosis of LAD, LCX, RCA or LM, RCA is more than75percent according to Quantitative coronary angiography. Normal coronarography group:the three coronary artery are smooth without narrow. For all selected objects, history was taken and body weight, height, and waist circumference (WC) were measured. Routine blood test, blood coagulation and renal functions were measured at the moment of admission. At the next morning of admission peripheral venous blood was taken for the measure of fasting blood glucose (FPG), blood lipids and liver functions. And another6ml elbow vein blood was taken, and3ml of which after centrifugation the upper serum was saved at the condition of-80℃for the detection of sCD36, another3ml of that anticoagulant, isolate the white blood cells immediately, and stored at-80℃for extraction of genomic DNA. SPSS17.0were used for statistical processing of data. Results:(1)There was significant difference about serum sCD36level between the two groups, premature coronary heart disease group with a significantly higher sCD361evels than that of the control group(t=2.044, p=0.043).(2)At the gene level, there was no significant difference between the two groups in the genotype proportion of rs1049673polymorphism, but the disease group has a higher C allele frequency than the control group, indicating there was a trend that the disease group has a higher C allele frequency.On the other hand, people with the CC genotype has a higher LDL-c level than the one with GG genotype,the difference was statistically significant (F=3.094, p=0.015). Logistic regression analysis revealed that after a number of confouding factors were excluded, CC and/or CG genotype is one of the independent risk factors for CHD (p=0.018), the one with CC and/or CG genotype suffering from the2.998times the risk of CHD than whose with GG genotype. There exist multiplicative model interactions of different degrees between CD36gene rs1049673mutation and environmental factors. rs1049673mutation of CD36gene amplification the effect of hypertriglyceridemia and has synergistic effect it. The mutation also has synergies effect with high low-density lipoprotein hyperlipidemia before adjust the risk factors, when adjusted risk factors the effect changed to antagonism, rs1049673mutation in diabetic patients with coronary heart disease have a relative protective effect. CD36gene rs1049673variation has antagonism effect with gender, it can reduc the role of the adverse effects of the male.Conclusion:Serum sCD36levels is one of the risk factors of coronary heart disease, could predict the happen of CHD. Gene CD36rs1049673polymorphism has some association with coronary heart disease. People carried CC and/or CG genotype suffering from the2.998times the risk of CHD than whose with GG genotype. C allele is one of the independent risk factors for CHD. There exist multiplicative model interactions of different degrees between CD36gene rs1049673mutation and environmental factors such as smoking, TG,LDL-c,DM,and gender in the present study population. |
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