The Study About The Association Between The Polymorphisms Of The Estrogen Receptor(ER) And Coronary Artery Disease Or Thelipoprotein Metabolism In Women

Objective:Coronary artery disease(CAD) is not neglected to the older for its high incidence and motality. The woman is differrent from the man in diagnosis, therapy, prognosis of CAD. The incidence of CAD is increased in postmenopausal women, which suggests that estrogen may have protective effects to the cardiovascular system. But the mechanism is not very clear. We analyzed the two of estrogen receptor (ER) polymorphisms as well as examined the association between the coronary artery disease or lipoprotein metabolism and the two polymorphisms in ER.Methods:One hundred and five people were entered into this study. Fifty-one patients with either MI (twenty-nine) or angina pectoris (twenty-two) and fifty-four control subjects were analyzed. All control subjects and patients except ten with MI were evaluated by coronary angiogrophy. An effected vessel was defined as having >50% reduction lumen size. Clinical data including age, blood pressure, serum total cholesterol level, triglyceride level, HDL-cholesterol, LDL-cholesterol and diabetes status werecollected from medical records of patients. For patients with MI, ages at their first events were recorded, whereas for patients of angina pectoris and the control subjects, ages at which coronary angiography was performed were recorded. No individual in this study population was receiving or had previously received hormone replacement therapy. Preparation of genomic DNA and determination of ER genotypes are got by molecule biological method. The association between the genotypes of ER and the number of the affected vessels, the severity of the lesions, the serum lipid level was analyzed separately.ResultsrLDL-cholesterol level of the patients whose genotype is "PP" is significantly higher than those whose genotype is "pp"(q=4.28 PO.01). no association was found between the polymorphisms and the affected vessel numbers (pvu II polymorphism x 2=0.196 P>0.05 ; xba I polymorphism x2=Q.2\9 P>0.05) or the reduction of the lumen size(pvull polymorphism x2-1.378 P>0.05; xba I polymorphism x 2=0.998 P>0.05). ER polymorphism is related to the serum lipid level.Conclusion:The cardiovascular protective effects of estrogen are known to be mediated by its beneficial effects on lipid metabolism and its direct actions on the vessel wall. The latter can be mediated by the specific receptor for estrogen present on smooth muscle cells and endothelial cells, the pvu II polymorphism is related to lipoproteinmetabolism, The populations whose genotypes are "PP" perhaps have the disorder of the lipid metabolism easier than those whose genotypes are "pp", and so, which may increase the risk of CAD.