低血糖控制和9p21位点之间对2型糖尿病冠状动脉疾病风险的相互作用
Alessandro Doria1, Joanna Wojcik, Rui Xu
1Research Division, Joslin Diabetes Center, Department of Medicine, Harvard Medical School, Boston, MA 02215, USA. alessandro.doria@joslin.harvard.edu
JAMA
|November 27, 2008
概括
9p21基因变异在2型糖尿病患者中增加冠状动脉疾病 (CAD) 风险,特别是当与低血糖控制相结合时. 这种相互作用显著放大了CAD和死亡率的风险.
科学领域:
- 遗传学 是一个遗传学.
- 心脏病学 心脏病学
- 内分泌学 在内分泌学.
背景情况:
- 一个常见的9p21染色体等位基因与一般人群中冠状动脉疾病 (CAD) 风险有关.
- 这种9p21变异对2型糖尿病人群中CAD风险的影响尚不清楚.
研究的目的:
- 调查9p21基因变异与2型糖尿病患者的CAD之间的关联.
- 评估9p21变种与低血糖控制对CAD风险和死亡率的相互作用.
主要方法:
- 一项病例控制研究涉及734名2型糖尿病患者 (322名患有CAD,412名没有).
- 一项独立的队列研究监测了475名2型糖尿病患者的10年死亡率.
- 参与者被基因型为9p21单核酸多态 (rs2383206) 并评估长期血糖控制 (HbA1c).
主要成果:
- 对于9p21风险等位基因具有同位合的个体,CAD发病率显著更高 (42.3%与28.9%相比).
- 与9p21变体相关的CAD风险因血糖控制不佳而大大增加 (相互作用P = .048).
- 低血糖控制与9p21风险基因型相结合,增加了CAD几率的4倍和10年死亡风险.
结论:
- 9p21基因变异在2型糖尿病患者中增加冠状动脉疾病的风险.
- 这种增加的风险被低血糖控制的存在显著加剧.
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