| Objective:There is consistent and convincing evidence that supports an association between dyslipidemia and the occurrence and development of coronary heart disease (CHD), especially,the levels of low density lipoprotein cholesterol(LDL-c).CD36,as the main receptor of the metabolism of LDL-c, also involved in the metabolic of long-chain fatty acid and triglyceride,which can promote the occurrence and development of CHD. The purpose of this study is to explore the risk factors of premature three-vessel coronary artery lesions,and then research the association beween CD36gene rs7755and rs3211956SNP and premature three-vessel coronary artery lesions at the gene level.Methods:Totally consecutive174cases of hospitalized patients were collected from the Second Hospital of Tianjin Medical University during October2010to December2012. All cases accepted coronary angiography.98cases were male, and76cases were female. According to age and the result of coronary angiography,all cases were divided into the lesion group (early-onset of three-vessel coronary artery lesions) and the normal control group(102and72respectively). Inclusion criteria:the lesion group:the onset age of CHD for female less than65years old and for male is less than55years old; three-vessel coronary artery lesions indicates the area stenosis of LAD, LCX, RCA or LM, RCA is more than50percent according to Quantitative coronary angiography, and, at least one area stenosis is more than70percent. Normal coronarography group:the three coronary artery are smooth without narrow.For all selected patients,medical history icluding smoking,drinking alchol, diabetes mdllitus(DM),hypertention, family history of early onset CHD and so on were taken,and body mass index (BMI) was calculated. Blood routine test, blood coagulation, renal functions and so on were measured at the moment of admission,the next morning,liver functions, blood lipid level and so on were measured. Another3ml elbow vein blood were taken, which was anticoagulanted, isolated the white blood cells immediately, and stored at-80℃for extraction of genomic DNA. SPSS17.0were used for statistical processing of data.Results:1. The ratios of male, slmoking, DM, family history of early onset CHD, drinking alchol and value of WBC, FBG, BMI, TG, TC, LDL-c, Scr, UA, LVEDD, were significantly higher in the lesion group vs the normal control group(P<0.05); while, the value of HDL-c and LVEF were lower in the lesion group. Logistic regression analysis revealed that, male, DM, High LDL-c, low HDL-c, the CD36gene rs7755and rs3211956variation were the independent risk factors of premature three-vessel coronary artery lesions (P<0.05);2.rs7755SNP:①there was no significant difference in the genotype proportion of rs7755polymorphism between the two groups,but the G allele proportion in the lesion group was significant higher (P<0.05);②patients with the GG genotype have a higher BMI level than those with AA or AG or AA+AG genotype, the difference was significantly (P<0.001); however, patients with the GG genotype have a lower HDL-c level than those with AA or AG or AA+AG genotype, the difference was significantly (P<0.05);③Logistic regression analysis revealed that,after excluded a number of confounding factors, G allelic genes is one of the independent risk factors for premature three-vessel CHD (P=0.009), the one with GG and/or AG genotype suffering from3.102times the risk of CHD than whose with AA genotype;2. rs3211956SNP:①The TT genotype proportion of rs3211956in the lesion group was significantly hihger (χ2=8.045,P=0.018), but the allele proportion in the two group was no significant difference;②patients with the TT genotype have a higher BMI level than those with GG or GT or GG+GT genotype, the difference was significantly (P<0.001);③Logistic regression analysis revealed that,after excluded a number of confounding factors, TT genotype is one of the independent risk factors for premature three-vessel CHD (P=0.027), the one with TT genotype suffering from2.318times the risk of CHD than whose with GG or GT genotype.Conclusion:1. the independent risk factors of premature three-vessel coronary artery lesions is male, DM, High LDL-c, low HDL-c;2. patients with the rs7755G allele has lower HDL-c and higher BMI; patients with the rs3211956T allele has BMI;3. After excluded a number of confounding factors, the one with rs7755GG and/or rs7755AG genotype suffering from3.102times the risk of CHD than whose with rs7755AA genotype; while the one with rs3211956TT genotype suffering from2.318times the risk of CHD than whose with rs3211956genotype. |
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