Molecular Epidemiological Reserch Of The Internal And External Environmental Interaction Between Diffrernt Traditional Chinese Medicine Syndromes Of Essential Hypertension And Polymorphism Of AT1R Gene

Objective:This paper based on observing all different TCM syndromes of hypertension patientswith angiotensin Ⅱ type l receptor (AT1R) A1166C and T573C polymorphism. Itobserves the influencing factors such as blood pressure, body mass index, blood lipid,blood glucose, living habit, blood biochemical indexes and vasoactive substances ofrenin angiotensin system (RAS) at the sametime. By analyzing the interactionbetween the influencing factors and polymorphism of AT1R gene, it discusses thevalue of gene polymorphism in TCM syndromes differentiation and the ineraction’sinflunce for essential hypertension. This study provides new ideas and new methodsin preventing and treating hypertension with TCM.Methods:1. According “the China high blood pressure control guide2010” diagnosis andexclusion standard, clinical screening400patients EH group, and in accordance with"the Chinese herbal medicine clinical research guiding principle" in hypertensiontypification standard, hypertension is divided into liver-fire hyperactivity, excessivephlegm-dampness, yin defidiency and yang hyperactivity, yin yang defidiency.Meanwhile, select the healthy control group of100patients who were healthy overthe same period.2. Recorded age, sex, smoking history, alcohol consumption, hypertension familyhistory, etc by questionnaires. Measure blood pressure (use of mercurysphygmomanometer), height, weight, calculate body mass index (BMI=weight/height2), and test blood sugar, blood fat (adopts automatic biochemistryanalyzer determined).3. Used enzyme linked immuno sorbent assay (ELISA) to test the level ofangiotensinogen (AGT), angiotensin-converting enzyme (ACE) and angiotensinⅡ (AngII)4. Used iMLDR gene polymorphism to detecte AT1R A1166C and T573C genepolymorphism.5. Used multifactor dimensionality reduction (MDR) to analyze the interactionbetween environmental factors and AT1R gene polymorphism.Results:1. The result indicated that EH group and control group was significant difference inalcohol consumption, dietary habit, family history, DBP, SBP,BMI, blood glucose(GLU), high density lipoprotein cholesterol (HDL-C), and low density lipoproteincholesterol (LDL-C)(P<0.05); There are some significant differences in sex, dietaryhabit, body mass index, family history, DBP, SBP, LDL-C, AGT between four groupsof TCM syndrome types (P <0.05).2. The result indicated that EH group and control group was significant difference inAGT, AngII and ACE (P<0.05). There is significant difference in AGT between fourgroups of TCM syndrome types (P<0.05). It has significant difference in AGTbetween yin yang defidiency with excessive phlegm-dampness.or control group. Theaverage from high to low of four groups of TCM syndrome types is: yin yangdefidiency＞liver-fire hyperactivity＞yin defidiency and yang hyperactivity＞excessive phlegm-dampness.3. Compaired with EH group and control group in AT1R A1166C polymorphism haveno significant difference (P>0.05), but T573C SNP TT+CT genotype and T allelehave significant difference (P<0.05). Liver-fire hyperactivity group compaired withexcessive phlegm-dampness group and yin yang defidiency in AT1R A1166C geneAA and CA genotype have significant difference(P<0.05). Yin yang defidency groupcompaired with control group in T537C gene T allele has significant difference(P<0.05).4. The result indicated the best diagnostic model of excessive phlegm-dampness symdrome and yin yang defidiency symdrome has the interaction of environmentalfactors with AT1R gene polymorphism. And the best diagnostic model of liver-firehyperactivity and yin defidiency yang hyperactivity group didn’t had interaction withAT1R gene and environmental factors. The the best diagnostic model of excessivephlegm-dampness syndrome is between BMI, LDL-C, dietary habit, alcoholconsumption and AT1R T573C gene polymorphism. The best diagnostic model ofyin yang defidiency symdrome is between LDL-C, BMI, alcohol consumption,dietary habit, and AT1R T573C gene. The best diagnostic model of liver-firehyperactivity symdrome is between LDL-C and BMI. And best diagnostic model ofyin defidiency yang hyperactivity is dietary habit. All the interactions above havestatistical significance (P<0.01). By using MDR to discover the interactions betweenAT1R gene and environmental factors of excessive phlegm-dampness group and yinyang defidiency group. After paring every two environmental factors of each groups,it showed that LDL-C, dietary habit, alcohol consumption and AT1R T573C genepolymorphism had stronger interaction in excessive phlegm-dampness group, andLDL-C, BMI, dietary habit, and AT1R T573C gene had stronger interaction in yinyang defidiency group.Conclusions:1. Unhealthy living habit such as alcohol consumption and excessive eating,hypertension family history is associated with the pathogenesis of hypertension.2. AGT, ACE and AngII may play a role in morbidity of hypertension. AGT mayaffect the formation of TCM syndromes.3. AT1R A1166C gene might not associate with the morbidity of hypertension forHan nationality in Hefei region; AT1R T573gene CT+TT genotype and T allele mayassociate with the morbidity of hypertension for Han nationality in Hefei region.AT1R A1166C polymorphism may associate with the morbidity of liver-firehyperactivity syndrome for Han nationality in Hefei region. AT1R T573C gene may associate with the morbidity of yin yang defidiency syndrome for Han nationality inHefei region.4. The interaction between environment factors and AT1R gene polymorphism maybe the best diagnostic model for the EH excessive phlegm-dampness sydrome and yinyang defidiency syndrome. And the interaction between environment factors may bethe best diagnostic model for EH liver-fire hyperactivity syndrome and yin defidiencyyang hyperactivity syndrome.