探討血脂(TG和HDL-C)濃度及膽固醇酯轉移蛋白(CETP)基因多型性與相關因子之關連性

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Title:	探討血脂(TG和HDL-C)濃度及膽固醇酯轉移蛋白(CETP)基因多型性與相關因子之關連性 Study on the association between high triglyceride, low high-density lipoprotein, and CETP gene polymorphism
Authors:	李春霖;Chuen-Lin Lee
Contributors:	公共衛生學院環境醫學研究所碩士班
Keywords:	三酸甘油脂;高密度脂蛋白膽固醇;膽固醇脂轉移蛋白(CETP);原住民;triglyceride;high-density lipoprotein;cholesteryl ester transfer protein(CETP);aborigine
Date:	2010
Issue Date:	2010-09-29 12:03:29 (UTC+8)
Abstract:	背景:過高的三酸甘油脂(TG)及過低的高密度脂蛋白膽固醇(HDL-C)為冠狀動脈心臟病的危險因子，也容易合併糖尿病、高血壓等病症。原住民三酸甘油脂與HDL-C異常的盛行率較非原住民要高，本研究以橫斷式研究探討原住民與非原住民CETP基因之TaqIB及I405V基因型和三酸甘油脂過高及HDL-C過低與環境因子之相關性。材料與方法：本研究對象為2007-2008年南投縣信義鄉及台中市中西區接受「全民健康保險成人健檢」者共805人(台中市中西區338人南投縣信義鄉467人平均年齡為61.0±11.6歲)，其中原住民280人，非原住民525人。收集問卷資料及測定生理生化值，以聚合酶鏈鎖反應-限制片段長度基因多型性試驗(PCR-RFLP)進行CETP基因之TaqIB及I405V基因型鑑定。結果：本研究發現原住民比非原住民有較高的比率抽菸、飲酒、嚼食檳榔和較低的喝咖啡及喝茶習慣。原住民三酸甘油脂異常合併有較高的膽固醇異常和糖尿病，非原住民HDL-C異常易合併糖尿病和高尿酸血症，而在調整干擾因子後，本研究並未發現CETP基因之TaqIB及I405V基因型與這些疾病的關聯性。控制干擾因子後，原住民有飲酒習慣之三酸甘油脂異常的風險比起沒有者為4.5倍(95% CI=1.92–10.49)，有嚼食檳榔習慣的人三酸甘油脂異常的風險比起沒有的為2.4倍(95% CI=1.20–4.90)。原住民帶有CETP之TaqIB基因型B1B2較B1B1之三酸甘油脂異常的風險為0.4倍(95% CI=0.19–0.95)。結論：原住民有飲酒及嚼食檳榔習慣為三酸甘油脂異常的危險因子，而CETP基因之TaqIB B2對偶基因為三酸甘油脂異常的保護因子，然而並未發現CETP之TaqIB與I405V基因型和個人疾病史之關聯性。 Background：High triglyceride(TG) and low high-density lipoprotein(HDL) are independent risk factors of coronary artery disease(CAD). The prevalence rates of high triglyceride and low high-density lipoprotein in a small population of Taiwanese aborigines were higher than those found in non-aboriginal. In this study, we examined the associations among high triglyceride, low high-density lipoprotein, CETP gene polymorphism and related factors. Methods：This study recruited 805 subjects (280 aborigines and 525 non-aborigines) who lived in the Hsin-Yi area of Nantou County and Taichung County in 2007-2008. Blood samples were collected from these participatants, and used for measuring biochemical markers. The CETP genotypes TaqIB and I405V were performed using the PCR-restriction fragment length polymorphism assay. Results：Aborigines were more prevalent than non-aborigines for health-risk habits such as: smoking, drinking and chewing betel nuts, and had lower rate of drinking tea and coffee, and exercise as well as. We found that aboriginals with high TG had high cholesterol and diabetes. Non-aborigines with low HDL were easily acquire diabetes and hyperuricemia, but we found no significant association between gene polymorphism and these diseases. Using multiple logistic regression analysis to adjuste confounding factors, we found that drinking and areca chewing habits significantly associated with high triglyceride in aboriginals (drinking : OR=4.5; 95% CI=1.92-10.49, areca chewing : OR=2.4; 95% CI=1.20-4.90). The aboriginal people with TaqIB B1B2 genotype, compare to those with B1B1, had significantly decreased risk for high triglyceride(OR=0.4; 95% CI=0.19-0.95). Conclusion：This study suggestes that drinking and areca chewing are risk factors for high triglyceride, while the CETP TaqIB B2 allele is the protective factor for high triglyceride among aborigines. However, we still don’t have strong evidence to demonstrate the association between TaqIB, I405V gene and CVDs in this study.
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