Study On The Correlation Between Apolipoprotein E Gene Polymorphism And TCM Syndromes Of Essential Hypertension

ObjectiveTo explore the relationship between the apolipoprotein E gene polymorphism and the TCM syndromes of hypertension,so as to provide reference for the study of the influence of apolipoprotein E gene polymorphism on the pathogenesis of hypertension and its mechanism from the perspective of metabolomics and proteomics,in order to facilitate the formation of the treatment aimed at the etiology of hypertension.At the same time,it is also helpful to understand the essence of TCM syndromes of hypertension from the perspective of heredity,to find the genetic basis of TCM syndromes of hypertension,to identify high-risk population,to facilitate the early prevention of hypertension,and to provide the basis for the objective study of TCM syndromes of hypertension.MethodsA retrospective study was conducted to select 120 patients with hypertension who visited Dongzhimen Hospital of Beijing University of Chinese Medicine from January 2018 to June 2019 according to the corresponding inclusion and exclusion criteria.To collect the basic information of the patients(name,gender,age and medical record number),personal history,(history of smoking and drinking),past medical history(coronary atherosclerotic heart disease history,diabetes history and history of hyperlipidemia),primary diagnosis,syndrome differentiation of traditional Chinese medicine information,apolipoprotein E gene polymorphism(genotype and phenotype)and blood fat information(triglycerides,total cholesterol,low-density lipoprotein cholesterol,high-density lipoprotein cholesterol).Microsoft Excel was used for data entry and SPSS 20.0 was used for data statistics.Results1.Age,gender,smoking history,drinking history,and complications situation are all associated with the onset of hypertension.Increase of age,gender is male,history of smoking and drinking,and combined hyperlipidemia will all rise the prevalence or bring forward onset age of hypertension,meanwhile,combined with coronary atherosclerotic heart disease or diabetes has no correlation with onset age of hypertension.Among them,the earlier onset of male patients may be associated with smoking histor and drinking history.2.The apolipoprotein E genotype distribution in the patients included in this study isε3/ε3 type(65.0%)>ε3/ε4 type(16.7%)>ε2/ε3 type(14.2%)>ε2/ε4 type(3.3%)>ε2/ε2 type(0.8%)>ε4/ε4 type(0.0%),phenotypes distribution is E3 type(68.3%)>E4 type(16.7%)>E2 type(15.0%)and allele frequency distribution is ε3(80.4%)>(10.0%)>ε2(9.6%).There is no significant difference in genotype distribution,phenotype distribution and allele frequency distribution between different genders.3.There was no correlation between apolipoprotein E gene polymorphism and the age of onset of hypertension,TCM syndromes,plasma triglyceride,total cholesterol and high-density lipoprotein cholesterol levels or whether combined with coronary atherosclerotic heart disease or hyperlipidemia.But apolipoprotein E gene polymorphism is related to concurrent diabetes.The frequency of the ε2 allele was lower in hypertension patients complicated with diabetes.Apolipoprotein E gene polymorphism is also associated with plasma low-density lipoprotein cholesterol level.The plasma low-density lipoprotein cholesterol level of E2 phenotype is lower than that of E3 phenotype in hypertensive patients,among them,the plasma low-density lipoprotein cholesterol level of E2 phenotypes in females was lower than that of E3 and E4 phenotypes,while there was no significant difference in plasma low-density lipoprotein cholesterol level among male with different phenotypes.4.The TCM syndrome distribution of hypertension patients is the syndrome of excessive phlegm-dampness(62.5%)>syndrome of deficiency of both Yin and Yang(15.8%)>syndrome of ascendant exuberance of liver fire(13.3%)>syndrome of Yin deficiency with Yang hyperactivity(8.3%).There is no significant difference in the syndrome distribution between different genders.5.History of drinking and concurrent coronary atherosclerotic heart disease are associated with TCM syndromes of hypertension.Hypertension patients combined with coronary atherosclerotic heart disease tend to have higher proportion of syndrome of excessive phlegm-dampness.Smoking history,age,course of disease,age of onset,blood lipid level,or whether combined with diabetes or hyperlipidemia are not associated with TCM syndromes in hypertension patients.6.There was no significant correlation between gene polymorphism of apolipoprotein E and the TCM syndromes of essential hypertension.However,based on the data characteristics,the ε4 allele of apolipoprotein E may be associated with the the syndrome of excessive phlegm-dampness in essential hypertension theoretically,and the association needs to be further verifiedConclusionThe gene polymorphism of apolipoprotein E may be associated with the TCM syndromes of essential hypertension,and the ε4 alleles may be associated with the syndrome of excessive phlegm-dampness in hypertension patients.Age increase,smoking history and drinking history may promote the onset of essential hypertension,and drinking may lead to the the occurrence of syndromes of excessive phlegm-dampness and ascendant exuberance of liver fire.The TCM syndromes of essential hypertension may be associated with both innate genetic factors and acquired environmental factors.