Hcy及其代谢关键酶MTHFR C677T基因多态性与OSAHS患者高血压的相关性研究

doi:10.6040/j.issn.1673-3770.0.2022.166

摘要/Abstract

摘要： 目的探讨同型半胱氨酸(Hcy)及其代谢关键酶亚甲基四氢叶酸还原酶(MTHFR)C677T基因多态性与阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者高血压的相关性。方法收集OSAHS患者85例、非OSAHS患者77例。检测所有研究对象的基因型、血清Hcy、空腹血糖、糖化血红蛋白。比较基因型间的血清Hcy水平;比较OSAHS合并高血压、OSAHS不合并高血压、非OSAHS不合并高血压组组间的Hcy水平、基因多态性、等位基因频率,单因素及多因素Logistic回归分析探讨OSAHS患者高血压风险的独立危险因素。结果 CC、CT、TT基因型的Hcy水平分别为10.11(9.15,11.07)mol/L、10.86(9.58,11.10)mol/L、15.81(11.43,50.76)mol/L,TT基因型Hcy水平高于CT基因型(P=0.005)及CC基因型(P<0.001);OSAHS合并高血压组、OSAHS不合并高血压组、非OSAHS不合并高血压组的Hcy水平分别为11.21(10.08,13.60)mol/L、9.93(9.30,11.42)mol/L、10.32(9.33,11.23)mol/L,OSAHS合并高血压组Hcy水平高于OSAHS不合并高血压组(P=0.027)及非OSAHS不合并高血压组(P=0.039)。控制其他混杂因素后显示高同型半胱氨酸血症(HHcy)是OSAHS患者的高血压的独立危险因素,OR值为4.160,95% CI(1.054,16.418)。三组间基因多态性及等位基因频率差异无统计学意义。结论 MTHFR C677T基因多态性影响血清Hcy水平,其TT型高于CT型及CC型;HHcy是OSAHS患者合并高血压的独立危险因素;MTHFR C677T基因多态性及C/T等位基因频率与OSAHS人群的高血压风险无关。

关键词: 阻塞性睡眠呼吸暂停低通气综合征, 同型半胱氨酸, 亚甲基四氢叶酸还原酶C677T, 高血压

Abstract: Objective The aim of this study was to investigate the relationships between homocysteine(Hcy)concentration and the C677T gene polymorphism in its key metabolic enzyme, methylenetetrahydrofolate reductase(MTHFR), and hypertension in patients with obstructive sleep apnea hypopnea syndrome(OSAHS). Methods Eighty-five patients with OSAHS, diagnosed by sleep monitoring, and 77 patients without OSAHS were included in this study. We determined MTHFR gene polymorphisms and serum Hcy, fasting blood glucose, and hemoglobin A1c concentrations in blood samples collected from all patients. Serum Hcy concentrations were compared between the TT, CT, and CC genotypes of the MTHFR C677T polymorphism. The Hcy concentration, MTHFR C677T genotype, and C/T allele frequency were compared between patients with OSAHS and hypertension, patients with OSAHS without hypertension, and the patients without OSAHS and hypertension. The factors associated with hypertension in OSAHS patients were evaluated using univariate and multiple Logistic regression analyses. Results The Hcy concentrations for the CC, CT, and TT genotypes were 10.11(9.15, 11.07)mol/L, 10.86(9.58, 11.10)mol/L and 15.81(11.43, 50.76)mol/L, respectively. Hcy concentrations were higher for the TT genotype than the CT(P=0.005)and CC(P<0.001)genotypes. The Hcy concentrations in patients with OSAHS and hypertension, patients with OSAHS without hypertension, and patients without OSAHS and hypertension were 11.21(10.08, 13.60)mol/L, 9.93(9.30, 11.42)mol/L and 10.32(9.33, 11.23)mol/L, respectively. Hcy concentrations were higher in patients with OSAHS and hypertension than in patients with OSAHS without hypertension(P=0.027)and patients without OSAHS and hypertension(P=0.039). After controlling for other confounding factors, hyperhomocysteinemia(HHcy)concentration was an independent risk factor for hypertension in patients with OSAHS(OR=4.160; 95%CI: 1.054, 16.418). There were no statistically significant differences in MTHFR C677T genotype or C/T allele frequency among the three groups. Conclusion The MTHFR C677T polymorphism affects serum Hcy concentrations, with the TT genotype showing higher concentrations than the CT and CC genotypes. HHcy concentration is an independent risk factor for hypertension in OSAHS patients, but neither the MTHFR C677T polymorphism nor the C/T allele frequency were associated with hypertension in OSAHS patients.

Key words: Obstructive sleep apnea hypopnea syndrome, Homocysteine, Methylenetetrahydrofolate reductase C677T, Hypertension

中图分类号:

陈尚丽,秦涛,陈璇,陈若瑾,唐智. Hcy及其代谢关键酶MTHFR C677T基因多态性与OSAHS患者高血压的相关性研究[J]. 山东大学耳鼻喉眼学报, 2023, 37(4): 126-133.

CHEN Shangli, QIN Tao, CHEN Xuan, CHEN Ruojin, TANG Zhi. Association between homocysteine concentration and the MTHFR C677T polymorphism and hypertension in patients with obstructive sleep apnea hypopnea syndrome[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2023, 37(4): 126-133.

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