| Objective:to study the effect of the interaction between the polymorphism of endothelial lipase rs2000813,rs3813082 gene and the environment on the susceptibility of coronary heart disease(CHD).Methods:900 patients in the coronary heart disease group and 900patients in the control group who were hospitalized in our hospital from January 2019 to December 2021 were selected and divided into the modeling group and the validation group according to the ratio of 8:2.The effects of rs2000813 and rs3813082 gene polymorphisms on coronary heart disease and blood lipid metabolism were compared between the two groups in the modeling group;Spearman correlation,single factor and multivariate logistic regression were used to analyze the risk factors of female coronary heart disease;Multi-factor dimensionality reduction method was used to analyze the interaction between genes and genes and between genes and environment;Models Y1,Y2,Y3 and Y4 were constructed to predict the risk of coronary heart disease in women.The ROC curve was used to evaluate the model differentiation,and the calibration map was used to evaluate the model calibration.Results:(1)This study found that there was no statistical difference in the distribution of different genes at rs2000813 and rs3813082 between the case group and the control group.After gender stratification,the CT genotype frequency at rs2000813 locus in the female coronary heart disease group was 113(49.30%)higher than that in the control group 91(37.80%),and the CC genotype frequency was 103(45.00%)lower than that in the control group 133(55.20%),with statistical significance(P<0.05).(2)This study found that the LDL/HDL ratio of the rs2000813CT genotype in the control group was higher than that of the CC genotype,while the LDL/HDL ratio of the CT genotype in the case group was higher than that of the TT genotype,with statistical significance(P<0.05);The TG levels of the rs3813082AC genotype in the control group females and the case group males were higher than those in the AA genotype,with a statistically significant difference(P<0.05).(3)Multivariate logistic regression analysis found that hypertension,age≥60 years old,BMI≥28kg/m~2,TC≥6.2mmol/L,APOB≥1.1g/L,and rs2000813CT genotype may be risk factors for coronary heart disease in women(P<0.05).(4)Multi factor dimensionality reduction analysis of gene environment interaction showed that:single attribute Main effect BMI(12.62%)>NE(5.69%)>PLT(5.19%)>WBC(4.15%)>Hypertension(3.06%)>age(2.69%)>Diabetes(2.13%)>TC(2.03%)>APOB(1.92%)>smoke(1.79%)>drink(1.3%)>rs2000813(0.99%)>Lpa(0.72%)>rs3813082(0.10%);The positive interaction between rs2000813 and rs3813082 was the highest(0.50%),while the negative interaction between BMI and NE was the highest(-7.05%).(5)The model Y4 constructed by rs2000813CT and rs2000813CC genotypes in combination with traditional cardiovascular disease risk factors(smoking,drinking,hypertension,diabetes,coronary heart disease,age≥60 years,BMI≥28kg/m~2,TC≥6.2mmol/L,APOB≥1.1g/L,Lpa≥300g/L,WBC>10*10^9/L,NE≥7.0*10^9/L,PLT≥300*10^9/L)predicted the risk of coronary heart disease in women with AUC of 0.804[95%CI(0.766,0.843)]and the best calibration.Conclusion:Endothelial lipase rs2000813CT genotype may be a risk factor for female coronary heart disease,and rs2000813CC genotype may be a protective factor for female coronary heart disease;Interaction between endothelial lipase gene and environment synergistically affects the occurrence of coronary heart disease in women;Endothelial lipase gene combined with traditional cardiovascular disease risk factors can better predict the risk of coronary heart disease in women. |
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