The Association Of The Cholesterol Ester Transfer Protein TaqIB Polymorphism With The Plasma Lipids In Patients With Acute Coronary Syndrome

Background:Atherosclerotic disease in heart and brain can do harm to human beings.Acute coronary syndrome(ACS)are due to rupture of unstable plaque in coronaries,then blooding,thrombosis forming and obstruction in coronaries.It is the most serious and emergency heart event in atherosclerotic diseases.In resent years, more and more young individuals are suffering from this disease.As an important risk factor,dyslipidemia is linked to atherosclerosis.At present,many researches have proved the important role of the TaqIB polymorphisms of cholesterol ester transfer protein(CETP)in the lipid metabolism.Statins have proved one of the most important therapies in atherosclerotic diseases.It is necessary for us to investigate the association of the lipid metabolism and CETP TaqIB polymorphisms,to search the relationship between statins and genes.As can influence the value of risk factors and therapy of ACS.Objective To observe the feather of risk factors,especially lipid metabolism in acute coronary syndrome(ACS)individuals.To investigate the association of the cholesterol ester transfer protein(CETP)TaqIB polymorphism with the plasma lipids level in patients with ACS.and the association of CETP TaqIB polymorphism with the effect of simvastatin in patients with ACS.To search the feature of lipid metabolism among different ages.Methods 246 subjects with angiographically documented coronary atherosclerotic disease(CAD)and 42 normal subjects(excluded by coronarogrophy)were included. 246 patients were divided into stable CAD group and ACS group.The latter were further divided into two subgroups according to whether the patients suffer from X syndrome or not.Plasma lipids were measured enzymatically in an MERCKMEGA analyzer.Restriction fragment length polymorphism(RFLP)analysis was performed to screen the CETP TaqIB polymorphism.ANOVA was applied to analyse the relationship between the CETP TaqIB polymorphism and plasma lipids.Plasma lipids were remeasured after three months therapy of simvastatin.The effect of simvastatin was valued among the three genotypes.The ACS patients were further divided in various subgroups according to their ages.The lipid level were analyzed by ANOVA. The relationship was determined between ages and lipid level.Results1.Between the CAD and the control group,significant difference was observed such as glucose,ISI,smoking and over drinking.Compared with the control group,the TC,LDL and lipoprotein(a)levels were higher in CAD patients(p＜0.05).But no significant different was observed in TG and HDL levels between the two groups.2.The hsCRP level in ACS patients is much higher than that in stable CAD group. The HDL level in ACS patients is lower than that in stable CAD group and the control.3.No significant difference was found in the frequencies of CETP TaqIB genotype and alleles between the ACS patients and the normal subjects(p＞0.05).The difference was found about the prevalence of the alleles B1 and B2 in the two ACS groups with and without X-syndrome(p＜0.05).4.Compared with B1B1 group,there was a increase of HDL in B1B2 group (p=0.005).Difference was observed of plasma HDL level between B1 and B2 alleles. When TG＜1.7mmol/L,there was a significant reduction of HDL level in the B1B1 genotype compared with the B1B2 one(p=0.012).While TG=1.7mmol/L,there was no difference of plasma lipids level in any of the three genotypes(B1B1,B1B2 and B2B2).5.There was no difference of plasma lipids level between B1B1 group and B2 group, when the ACS patients suffer from X-syndrome.While there was a significant reduction of HDL level in the B1B1 genotype compared with the B2 group when X-syndrome was excluded in the ACS patients.6.After three months therapy of simvastatin,TC and LDL in all of the ACS patients and lipoprotein(a)in part of them were significantly decreased(p＜0.001).But no difference was observed in any of the three genotypes.Compared with the B1B1 group,the level of TG in two groups(B2B2 and B1B2)was significantly decreased after the therapy of simvastatin(p＜0.01).7.The HDL cholesterol level of young ACS patients under 65 is lower(p=0.042)than that of old ones,while the triglyceride level is higher(p=0.004).Compared with the control group,the TC,LDL and lipoprotein(a)levels were higher in both young and old individuals(p＜0.05).But no significant different was observed in TC,LDL and lipoprotein(a)levels levels between the two subgroups.Conclusion:ACS patients developed significantly increasing TC,LDL and lipoprotein(a).No significant difference was found in the frequencies of B1,B2 alleles between the controls and ACS patients.Compared with B1B1 group,there was a increase of HDL in B1B2 group.The level of TG in B2B2 group was significantly decreased after the therapy of simvastatin.TG and TaqIB polymorphism would inference the level of HDL in CAD patients without X-syndrome.