Relationship Between Angiotensinogen Gene Polymorphism And Essential Hypertension And Other Indexs

Objective : To investigate the association between angiotensinogen (AGT)gene polymorphism and essential hypertension. Methods : 1.Design research form in TCM syndromes of hypertension according to the Guide Book of New TCM Pharmaceutic Clinical Research(2002 edition), fill in precise clinical materials.2. We selected 140 patients with essential hypertension and 40 normotensive control to carried out case-control study .3.Two doctors in high-grade professional title made out differentiation of syndrome according to the clinical materials and took out syndrome conclusion . 4. All of subjects extracted DNA from periphery white blood cell ,Polymerase chain reaction combined with restrict enzyme digestion (PCR-RFLP) was used to detect the target gene polymorphism ,used agarose gel or 8% polyacrylamide gel to detect genotype ;use radition compared with nebecula means to detect Hs-CRP and radition immunization means to detect FINS ;5 The statistical evaluation was performed with SPSS 13.0 software for windows ,measurement datas used One-Way ANOVA ;numeration data used Chi-Square Tests ;use the step wise discrimination analysis and stepwise logistic regression and discrimination analysis to analyzed variables . Results : 1.TCM syndromes of hypertension and convention indexs :â‘ association between TCM syndromes and BMI : control group have statistics difference with all of syndromes except liver-fire hyperactivity;Among TCM syndromes,yin defidiency and yang hyperactivity have no statistics with yin yang defidiency(P>0.05),the rest of them compared with each other , whole of them have statistics significance (P<0.05).Compared with WHR: control group have statistics difference with all of syndromes except yin yang deficiency ,Among syndromes liver-fire hyperactivity have statistics difference with phlegm-dampness and yin deficiency yang hyperactivity (P<0.05). phlegm-dampness have statistics difference with yin yang deficiency (P<0.05),rest of other syndromes have no statistics difference (P>0.05).â‘¡TCM syndromes compared with Blood fat : three syndromes compared with control group in TG have statistics difference (P < 0.05 ) ,excessive phlegm-dampness compared with yin yang deficiency and yin deficiency yang hyperactivity have statistics difference (P < 0.05 ) , liver-fire hyperactivity compared with excessive phlegm-dampness and yin yang deficiency in TG have statistics differdence (P < 0.05 ) ; Liver-fire hyperactivity and excessive phlegm-dampness TC level highest in TCM syndromes , have statistics difference with control group and yin yang deficiency(P<0.05);In five groups ,HDL decreased obviously in excessive phlegm-dampness ,have statistics difference with control group,liver-fire hyperactivity and yin deficiency yang hyperactivity (P<0.05);LDL increased obviously in yin yang deficiency , compared with liver-fire hyperactivity,yin deficiency yang hyperactivity,control group have statistics difference(P<0.05);All of syndromes Lpa increased compared with control group have statistics difference(P<0.05),each of them have no statistics difference(P>0.05).â‘¢Compared with FINS,IR,Hs-CRP: FINS and IR in four syndromes high than control group(P<0.05),excessive phlegm-dampness was the highest than the other syndromes(P<0.05), liver-fire hyperactivity compared with yin yang deficiency have statistics on FINS ,but not on IR ;Hs-CRP increased in four syndromes than control group(P<0.05),but have no statistics difference in each of them( P>0.05).2. Hardy-Weinberg equilibrium test indicated that The frequencies of TT,MT,MM M235Tgenotype in hypertensive patients were(X~2=0.696,P=0.404>0.05), normotensive controls were (X~2=0.745,P=0.388>0.05);T174M genotype in hypertensive patients were(X~2=0.563,P=0.453>0.05),normotensive controls were(X~2=1.017,P=0.313>0.05),P>0.05 indicated that the genotype of both gene locus M235T and T174M in the hypertensive patients or normotensive controls we studied having group representation .3. The comparison of the frequencies of TT,MT,MM genotype and T,M allele in hypertensive patients and normotensive controls :â‘ M235T having high significance statistics difference (X~2=34.087,P=0.000<0.05):The frequencies of TT,MT,MM genotype in hypertensive patients and normotensive controls were (57.1% vs 22.5%,38.5% vs 42.5%,4.4%vs 35.0%);The frequencies of T allele and M allele in hypertensive patients and normotensive controls(76.4% vs 43.8%,23.6% vs 56.3%),difference having statistics significance (X~2=31.157,P=0.000<0.05).â‘¡T174M having no significance statistics difference (X~2=1.877,P=0.391 > 0.05) : The frequencies of TT,MT,MM genotype in hypertensive patients and normotensive controls were (63.6% vs 72.5% ;33.6% vs 27.5% ;2.8% vs 0%). The frequencies of T allele and M allele in hypertensive patients and normotensive controls( 80.4% vs 86.3% ;19.6% vs 13.8% ),No statistically significant diferences were found between two groups (X~2=1.877,P=0.391>0.05 ;X~2=1.443,P=0.230>0.05 respectively ). 4 .The comparison of genotype and M,T allele between different syndromes of hypertension and control group :â‘ The frequencies of M235T genotype in control group having significance statistics difference(P<0.05) comparied with all of TCM syndromes except the sydrome of liver-fire hyperactivity (X~2=4.231,P=0.121>0.05 ) .The comparison of liver-fire hyperactivity and excessive phlegm-dampness have no significance statistics difference ( X~2 =1.979,P=0.372>0.05),The comparison of syndrome yin deficiency and yang hyperactivity with yin-yang deficiency was in the same (X~2=2.110,P=0.348>0.05),the rest of other syndromes comparied with each other ,all of them having statistics difference (P<0.05).â‘¡The frequencies of T174M genotype in control group having significance statistics difference comparied with syndrome of excessive phlegm-dampness(X~2=4.322,P=0.038<0.05),have no statistics difference with the rest of other syndroms (P>0.05),The comparison of liver-fire hyperactivity and excessive phlegm-dampness have significance statistics difference (X~2=5.436,P=0.020<0.05),the rest of other syndromes comparied with each other , all of them having no statistics difference (P>0.05).5 let the significance indexs chosed by one way-ANOVA and chi square test entered into the stepwise discrimination analysis and stepwise logistic regression discrimination analysis , received Classification Function Coefficients and constants , then established the Discriminant Function . Discriminant result displayed that,accuracy predictive value is 66.7% (10+34+26+10+40/180),sensitivity is 98.6%(138/140) , specificity is 100%(40/40).From this test we found when used logistic regression discrimination analysis in TCM syndromes of hypertension ,mixed liver-fire hyperactivity with yin deficiency yang hyperactivity and yin yang deficiency with yin deficiency yang hyperactivity. Conclusion : 1. Among different syndromes of hypertension ,the syndrome of excessive phlegm-dampness risks highest to get cornary artery heart disease and artherosclerosis .2. The M235T variation of AGT gene associated with the development of EH, TT genotype maybe the predisposing gene of EH .3. The T174M variation of AGT gene may not be associated with the development of essential hypertension ,maybe associated with TCM syndrome excessive phlegm-dampness.4. sthenia syndrome and asthenia syndrome maybe have difference in gene polymorphism .5. metabolic block and inflammation reaction condition are exist in hypertensive patients , we can judged from the high level of FINS and Hs-CRP expression .6. the result of the stepwise logistic regression and discrimination analysis were proved again that variables mentioned above have the important value to diagnose hypertension ,discriminant functions established have higher efficacy,can be used in clinic .