CAJ | 학술논문

目的：探讨早发冠状动脉粥样硬化性心脏病（CHD）的危险因素，及CD36基因rs7755和rs3211956单核苷酸多态性（SNP）与早发CHD的相关性。方法连续筛选冠状动脉造影证实的早发冠脉严重三支病变者（病变组）102例及冠脉造影正常者（正常组）72例，对比2组 CHD 的传统危险因素，并用质谱法检测所有入选者CD36 rs7755和rs3211956位点基因型，分析早发CHD的独立危险因素。结果传统危险因素中，男性、糖尿病、高血压、高低密度脂蛋白胆固醇（LDL-C）及低高密度脂蛋白胆固醇（HDL-C）是早发CHD的独立危险因素。病变组中rs3211956的GT基因型分布低于正常组（χ2=8.042，P=0.005），而TT基因型分布高于正常组（χ2=6.191，P=0.014）；TT基因型者较含G等位基因者的体质指数（BMI）水平增高（P=0.037）。病变组rs7755的G等位基因的频率高于正常组（χ2=3.636，P=0.047）；GG基因型的BMI水平高于A等位基因携带者（P＜0.001），而HDL-C水平低于另两种基因型者（P＜0.001）。Logistic回归分析显示在分别调整了混杂因素后，rs3211956基因型GG、TT及rs7755基因型GG、GA均为早发CHD的独立危险因素。结论 CD36 rs3211956、rs7755的SNP可能是致早发CHD的独立危险因素，且可能通过影响BMI和HDL-C而影响早发CHD的发生。
목적：탐토조발관상동맥죽양경화성심장병（CHD）적위험인소，급CD36기인rs7755화rs3211956단핵감산다태성（SNP）여조발CHD적상관성。방법련속사선관상동맥조영증실적조발관맥엄중삼지병변자（병변조）102례급관맥조영정상자（정상조）72례，대비2조 CHD 적전통위험인소，병용질보법검측소유입선자CD36 rs7755화rs3211956위점기인형，분석조발CHD적독립위험인소。결과전통위험인소중，남성、당뇨병、고혈압、고저밀도지단백담고순（LDL-C）급저고밀도지단백담고순（HDL-C）시조발CHD적독립위험인소。병변조중rs3211956적GT기인형분포저우정상조（χ2=8.042，P=0.005），이TT기인형분포고우정상조（χ2=6.191，P=0.014）；TT기인형자교함G등위기인자적체질지수（BMI）수평증고（P=0.037）。병변조rs7755적G등위기인적빈솔고우정상조（χ2=3.636，P=0.047）；GG기인형적BMI수평고우A등위기인휴대자（P＜0.001），이HDL-C수평저우령량충기인형자（P＜0.001）。Logistic회귀분석현시재분별조정료혼잡인소후，rs3211956기인형GG、TT급rs7755기인형GG、GA균위조발CHD적독립위험인소。결론 CD36 rs3211956、rs7755적SNP가능시치조발CHD적독립위험인소，차가능통과영향BMI화HDL-C이영향조발CHD적발생。
Objective To investigate the risk factors of premature atherosclerotic three-vessel coronary artery dis?ease (CHD), and the association between single nucleotide polymorphism (SNP) of CD36 rs3211956, rs7755 and premature CHD. Methods Patient with premature three-vessel coronary artery disease (n=102) which were confirmed by consecutive coronary angiogram (lesion group) and patients (n=72) without CHD (control group) were enrolled in the study. Conventional CHD risk factors were compared between the two groups as well as SNPs of CD36 rs3211956 and rs7755 to disclose inde?pendent risk factor for CHD, which were measured by mass spectrometry. Results Among the conventional CHD risk fac?tors, male, HBP, high LDL-C, low HDL-C were independent risk factors of premature CHD. The GT genotype proportion of rs3211956 was significantly lower (χ2=8.042,P=0.005) in the lesion group than that in control group while the TT genotype proportion is significantly higher in lesion group compared with that in control group (χ2=6.191,P=0.014). Patients with the TT genotype have higher score of BMI than patients with GG or GT genotype (P=0.037). The G allele proportion of rs7755 in the lesion group was significantly higher than control group (χ2=3.636, P=0.047). Patients of the GG genotype have higher scores of BMI but lower level of HDL-C than those with AA or AG genotype (P<0.001). Logistic regression analysis re?vealed that after excluding a number of confounding factors, GG and TT genotype of rs3211956 and GG and GA genotype of rs7755 were respectively one of the independent risk factors for premature CHD. Conclusion The SNPs of CD36 rs7755 and rs3211956 may be the independent risk factors of premature coronary heart disease and might affect the the onset of CHD by affectting BMI and HDL-C.