CAJ | 학술논문

目的探讨杀伤细胞免疫球蛋白样受体(KIR)基因多态性与原发性高血压的关联性.方法以社区资料为基础,采用病例对照研究方法,分析按年龄±2岁、同性别1∶1匹配的205对原发性高血压患者(病例组)和正常对照(对照组).应用PCR-SSP方法检测KIR基因,利用广义多因子降维模型(GMDR)和SAS 9.1软件分析数据.结果 KIR各基因频率在病例组和对照组间的差异无统计学意义(P＞0.05).KIR基因型9(不携带KIR3DSl和2DS3)在病例组的携带率高于对照组,差异有统计学意义(P＜0.05).GMDR显示,KIR2DS2和KIR2DS3两个基因的交互作用检验精确度最高(55.13％),交叉验证一致性为10/10,P=0.054.多因素分析显示,在调整了BMI、吸烟、饮酒和高血压家族史后,KIR2DS2阳性而KIR2DS3阴性者患原发性高血压的危险增加(OR=2.555,95％CI:1.203～ 5.429,P=0.015);KIR2DS2阳性且KIR2DS3阳性者患原发性高血压的危险降低(OR=0.268,95％CI:0.088～ 0.815,P=0.020);KIR2DS2阴性且KIR2DS3阳性者与原发性高血压不存在关联关系(OR=1.602,95％CI:0.785～ 3.266,P=0.195),与KIR2DS2阴性且KIR2DS3阴性者相比较.调整BMI、吸烟、饮酒和高血压家族史后,KIR2DS2和KIR2DS3的交互作用与原发性高血压显著关联(OR=0.065,95％CI:0.013～ 0.317,P=0.001).无论是未调整或经多因素调整后,KIR各基因及基因型与高血压均不存在关联关系(P＞0.05).结论携带KIR2DS2而不携带KIR2DS3者,患原发性高血压的危险增加;同时携带KIR2DS2和KIR2DS3可减少原发性高血压的患病危险,两者的拮抗作用可能是原发性高血压的保护因素.
목적 탐토살상세포면역구단백양수체(KIR)기인다태성여원발성고혈압적관련성.방법 이사구자료위기출,채용병례대조연구방법,분석안년령±2세、동성별1∶1필배적205대원발성고혈압환자(병례조)화정상대조(대조조).응용PCR-SSP방법검측KIR기인,이용엄의다인자강유모형(GMDR)화SAS 9.1연건분석수거.결과 KIR각기인빈솔재병례조화대조조간적차이무통계학의의(P＞0.05).KIR기인형9(불휴대KIR3DSl화2DS3)재병례조적휴대솔고우대조조,차이유통계학의의(P＜0.05).GMDR현시,KIR2DS2화KIR2DS3량개기인적교호작용검험정학도최고(55.13％),교차험증일치성위10/10,P=0.054.다인소분석현시,재조정료BMI、흡연、음주화고혈압가족사후,KIR2DS2양성이KIR2DS3음성자환원발성고혈압적위험증가(OR=2.555,95％CI:1.203～ 5.429,P=0.015);KIR2DS2양성차KIR2DS3양성자환원발성고혈압적위험강저(OR=0.268,95％CI:0.088～ 0.815,P=0.020);KIR2DS2음성차KIR2DS3양성자여원발성고혈압불존재관련관계(OR=1.602,95％CI:0.785～ 3.266,P=0.195),여KIR2DS2음성차KIR2DS3음성자상비교.조정BMI、흡연、음주화고혈압가족사후,KIR2DS2화KIR2DS3적교호작용여원발성고혈압현저관련(OR=0.065,95％CI:0.013～ 0.317,P=0.001).무론시미조정혹경다인소조정후,KIR각기인급기인형여고혈압균불존재관련관계(P＞0.05).결론 휴대KIR2DS2이불휴대KIR2DS3자,환원발성고혈압적위험증가;동시휴대KIR2DS2화KIR2DS3가감소원발성고혈압적환병위험,량자적길항작용가능시원발성고혈압적보호인소.
Objective To assess the association between killer cell immunoglobulin-like receptor (KIR) gene polymorphisms and the risk of hypertension in autoimmune mechanism.Methods We conducted a case-control study including 205 hypertensives and 205 controls matched with sex and age,from a community-based population.KIR genes of all subjects were genotyped by polymerase chain reaction with sequence-specific primers (PCR-SSP).Conditional logistic regression model and generalized multifactor dimensionality reduction (GMDR) method were used to estimate the association among KIR gene polymorphisms and the risk of hypertension.Results The genotypic frequencies of KIRs were not significantly different between the hypertensives and the control groups (P＞0.05).Among all the models of GMDR concerning the association between interactions of KIR genes and essential hypertension,the testing accuracy of the interaction between K/R2DS2 and KIR2DS3 was the highest (55.13％),with cross-validation consistency as 10/10 (P=0.054).Results from the conditional logistic regression showed that individuals with KIR2DS2 +:KIR2DS3-were significantly associated with an increased risk on hypertension (OR=2.555,95％CI:1.203-5.429,P=0.015).However,individuals with KIR2DS2 +:KIR2DS3 + were significantly associated with a reduced risk of hypertension (0R=0.268,95％ CI:0.088-0.815,P=0.020).Individuals with KIR2DS2-KIR2DS3 + did not seem to be associated with the risk of hypertension (0R=1.602,95％ C I:0.785-3.266,P=0.195),when compared to the KIR2DS2-KIR2DS3-group.Interactions between KIR2DS2 and KIR2DS3 were significantly associated with the risk of hypertension,after adjusted for BMI,smoking,drinking and family history of hypertension (OR=0.065,95％CI:0.013-0.317,P=0.001).Conclusion Individuals with KIR2DS2 and no KIR2DS3 were associated with the increased risk of hypertension.KIR2DS2 that coexisted with KIR2DS3 were associated with the reduced risk of hypertension.Antagonism between KIR2DS2 and KIR2DS3 might serve as a protect factor for hypertension.