Zaporožskij Medicinskij Žurnal (Dec 2016)
Gene polymorphism of aldosterone synthetase (CYP11B2) variants and main cardiovascular risk factors
Abstract
Background. Purpose of the work – to investigate the possible relationship of the cardiovascular risk main factors with certain polymorphism of aldosterone synthase gene (CYP11B2). Materials and methods. Аt the Cardiology Department of PL Shupyk NMAPE general clinical examination of 378 patients was held. Patients were divided into four groups: 100 patients with postinfarction cardiosclerosis, 78 patients with CAD without myocardial infarction in history, 100 high cardiovascular risk patients (with diabetes, hypertension or dyslipidemia) and 100 healthy patients (absence of cardiovascular disease was confirmed by medical history, ECG, blood pressure measurement and stress-ECG). Genetic testing was performed by polymerase chain reaction in real time at the Institute of Physiology named after O. O. Bogomolets. Exclusion criteria were hemodynamically significant valvular heart disease, chronic obstructive pulmonary disease, permanent or temporary heart pacing, acute heart failure and implanted cardioverter-defibrillator, permanent form of atrial fibrillation. Statistical analysis of the results was performed using Microsoft Excel, the statistical program SPSS (version 13US). Results. When analyzing the average levels of low density lipoprotein (LDL) cholesterol statistically significant difference between the group of patients with postinfarction cardiosclerosis and the group of high-risk patients (2.93±1.2 mmol/L vs 3.4±1.2 mmol/L, p=0.0075) was demonstrated, indicating a better cholesterol control in the group of patients with postinfarction cardiosclerosis, despite the fact that the average cholesterol level did not reach the target. The highest average levels of triglycerides (TG) were observed in patients with postinfarction cardiosclerosis – 1.56±0.725 mmol/L, intermediate – in patients with stable coronary artery disease – 1.39±0.795 mmol/L, and the lowest – in high cardiovascular risk patients – 1.04±0.565 mmol/L, with significant differences between all groups. The level of total cholesterol in patients with postinfarction cardiosclerosis was significantly higher in the subgroup of patients with homozygous recessive variant CC (5.8±1.08 mmol/L), compared with heterozygotes TC (4.87±1.3 mmol/L, p=0.024 ) and had no statistical significance when compared with the dominant TT homozygotes (5.06±1.45 mmol). Higher levels of total cholesterol (5.76±1.5 mmol/L) in TT homozygotes compared with TC (4.92±1.27 mmol/L, p=0.027) and CC (4.74±1.23 mmol/L, p=0.022) were found. In the group of patients with postinfarction cardiosclerosis, LDL cholesterol in the subgroup homozygous recessive variant CC was higher (3.43±0.87 mmol/L) (not significant) compared with a TT variant (3.02±1.3 mmol/L) and compared with heterozygotes TC (2.78±1.2 mmol/L, p=0.08). The level of TG in patients with stable coronary heart disease was the lowest in dominant homozygotes TT (1.13±0.56 mmol/L) compared with CT heterozygotes (1.54±0.97 mmol/L, p=0.08) and CC homozygotes (1.36±0.58 mmol/L, p=0.2). Conclusions. 1. Group of high cardiovascular risk patients requires special attention in the prevention of cardiovascular diseases, because this group showed the worst control of cardiovascular risk factors (level of total cholesterol, LDL cholesterol, glucose, SBP) in the absence of appropriate treatment. 2. Ingroup of patients with stable coronary artery disease and postinfarction cardiosclerosis the link CC variant gene polymorphism of aldosterone synthase CYP11B2-344C/T with higher levels of total cholesterol, LDL cholesterol was established, which increases the cardio-vascular risk in this group. 3. CC polymorphism of aldosterone synthase gene CYP11B2-344C/T was associated with higher levels of SBP in patients with stable coronary artery disease and postinfarction cardiosclerosis, which increases the cardiovascular risk such as the development of hypertension.
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