Haptoglobin phenotype is an independent risk factor for cardiovascular disease in individuals with diabetes: The strong heart study
Haptoglobin phenotype is an independent risk factor for cardiovascular disease in individuals with diabetes: The strong heart study
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DOI：
10.1016/s0735-1097(02)02534-2
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发表时间：
2002-12-04
影响因子：
24
通讯作者：
Howard, BV
中科院分区：
文献类型：
--
作者：
Levy, AP;Hochberg, I;Howard, BV
目的 本研究的目的是确定触珠蛋白表型是否可以预测糖尿病 (DM) 患者的心血管疾病 (CVD)。 背景 心血管疾病是 2 型 DM 最常见、最严重且费用最高的并发症。糖尿病患者的 CVD 风险存在明显的地理和种族差异，但不能用传统 CVD 风险因素的差异来完全解释。我们已经证明，触珠蛋白基因中的功能性等位基因多态性是糖尿病微血管并发症发生的易感性的主要决定因素。方法我们试图确定这种关于触珠蛋白基因的范例是否可以扩展到糖尿病的CVD。我们在“强心脏”研究的病例对照样本中检验了这一假设，该研究是一项针对美洲印第安人的基于人群的 CVD 纵向研究。通过聚丙烯酰胺凝胶电泳测定了 206 名 CVD 病例和 206 名年龄 45 至 74 岁的匹配对照者的触珠蛋白表型。中位随访时间为六年。 结果 在控制传统 CVD 危险因素的多变量分析中，触珠蛋白表型是 DM CVD 的高度统计学显着性独立预测因子。具有触珠蛋白 2-2 表型的 DM 中发生 CVD 的比值比是具有触珠蛋白 1-1 表型的 DM 的 5.0 倍 (p = 0.002)。 CVD 的中等风险与触珠蛋白 2-1 表型相关。结论本研究表明，触珠蛋白表型的确定可能有助于 CVD 风险分层中使用的算法，以及评估预防糖尿病患者 CVD 的新疗法。 (C) 2002 年由美国心脏病学会基金会资助。
OBJECTIVES The goal of this study was to determine if the haptoglobin phenotype was predictive of cardiovascular disease (CVD) in diabetic mellitus (DM).BACKGROUND Cardiovascular disease is the most frequent, severe, and costly complication of type 2 DM. There are clear geographic and ethnic differences in the risk of CVD among diabetic patients that cannot be fully explained by differences in conventional CVD risk factors. We have demonstrated that a functional allelic polymorphism in the haptoglobin gene acts as a major determinant of susceptibility for the development of diabetic microvascular complications.METHODS We sought to determine if this paradigm concerning the haptoglobin gene could be extended to CVD in DM. We tested this hypothesis in a case-control sample from the Strong Heart study, a population-based longitudinal study of CVD in American Indians. Haptoglobin phenotype was determined by polyacrylamide gel electrophoresis in 206 CVD cases and 206 matched controls age 45 to 74 years. Median follow-up was six years.RESULTS In multivariate analyses controlling for conventional CVD risk factors, haptoglobin phenotype was a highly statistically significant, independent predictor of CVD in DM. The odds ratio of having CVD in DM with the haptoglobin 2-2 phenotype was 5.0 times greater than in DM with the haptoglobin 1-1 phenotype (p = 0.002). An intermediate risk of CVD was associated with the haptoglobin 2-1 phenotype.CONCLUSIONS This study suggests that determination of haptoglobin phenotype may contribute to the algorithm used in CVD risk stratification, and in evaluation of new therapies to prevent CVD in the diabetic patient. (C) 2002 by the American College of Cardiology Foundation.