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Journal of Chinese Integrative Medicine ›› 2005, Vol. 3 ›› Issue (6): 438-442.doi: 10.3736/jcim20050605

• Original Clinical Research • Previous Articles     Next Articles

Study on relationship between polymorphism of apolipoprotein E gene and syndromes of phlegm and blood stasis in patients with coronary heart disease

Tao Ouyang1,2, Jian-nan Song1, Yang Miao3, Qian Lin4, Xiao-hong Niu1, Hong Jin1, Bing Chen1   

  1. 1. Department of Biochemistry, Institute of Basic Theory, China Academy of Traditional Chinese Medicine, Beijing 100700, China
    2. Department of Immunology, Beijing Institute of Geriatrics, Ministry of Public Health, Beijing 100730, China
    3. Department of Cardiology, Xiyuan Hospital, China Academy of Traditional Chinese Medicine, Beijing 100091, China
    4. Department of Cardiology, Dongfang Hospital, Beijing University of Traditional Chinese Medicine, Beijing 100078, China
  • Online:2005-11-20 Published:2005-11-20
  • Contact: Jian-nan Song E-mail:sjn2003@sina.com

Objective

To explore the relationship between polymorphism of apolipoprotein E (ApoE) exon 4 gene and different syndromes in patients with coronary heart disease (CHD).

Methods

Two hundred patients with CHD were divided into four groups according to syndrome differentiation, including syndrome of phlegm (PS), syndrome of blood stasis (BSS), syndrome of phlegm-blood stasis blocking (PBBS) and syndrome of non-phlegm and non-blood stasis (NPNBS). One hundred healthy volunteers were included in control group. Blood lipids were measured by routine examination. Total DNA of peripheral blood was extracted. ApoE genotypes were determined by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique. All data were analyzed by SAS software.

Results

(1) The occurrence rate of ε4 allele of ApoE in patients with CHD was 19.5%, significantly higher than 9.5% in the control group (P<0.05), and the E 3/4 genotype was especially more frequent (P<0.01). (2) The levels of total cholesterol (TC), total triglycerides (TG) and low-density lipoprotein cholesterol (LDL-C) in patients with ε4 were higher than those in patients without ε4 (P<0.01). (3) The frequencies of ε4 allele and E3/4 genotype in patients with PS were significantly higher than those in patients with BSS (P<0.05).

Conclusion

ApoE ε4 allele, especially E3/4 genotype, is the risk factor of CHD. There is a relatively close relationship between patients with ApoE ε4 allele and PS. It may be one of the main susceptible genes in CHD patients with PS.

Key words: Coronary heart disease, Apolipoprotein E, Gene polymorphism, Syndrome of phlegm and blood stasis

CLC Number: 

  • R2-03

Fig 1

PCR amplification results of ApoEexon 4 target fragment M: PCR marker; 1: PCR products; 2: PCR products"

Fig 2

HhaI RFLP results of ApoE exon 4 PCR products M: pBR322-Hae Ⅲ marker; 1: Genotype E 3/3; 2: Genotype E 2/3; 3: Genotype E 2/4; 4: Genotype E 2/2; 5: Genotype E 3/4; 6: Genotype E 4/4"

Fig 3

Sequence mapping of genotype E 4/4 of ApoE "

Tab 1

Frequency distribution of ApoE exon 4 genotypes and alleles in CHD group and control group"

Group n Genotype frequency [% (cases)] Allele frequency [% (cases)]
E 3/3 E 4/4 E 3/4 E 2/3 E 2/2 E 2/4 ε2 ε3 ε4
Control 100 66.0 (66) 2.0 (2) 14.0 (14) 17.0 (17) 0 (0) 1.0 (1) 9.0 (18) 81.5(163) 9.5 (19)
CHD 200 49.0 (98)** 2.5 (5) 33.5 (67)** 14.0 (28) 0.5 (1) 0.5 (1) 7.7 (31) 72.8 (291) 19.5 (78)*

Tab 2

Comparison of serum lipid level between patients in CHD group with and without ε4 allele ($\bar{x}$±s )"

Group n TC (mmol/L) TG (mmol/L) HDL-C (mmol/L) LDL-C (mmol/L) AI
E 2/2+E 2/3+E 3/3 127 4.18±1.13 1.53±1.05 1.16±0.46 2.36±0.93 2.40±1.38
E 2/4+E 3/4+E 4/4 73 4.98±1.25** 2.17±2.45* 1.09±0.42 2.90±1.00** 3.00±1.53**

Tab 3

Frequency distribution of apoE exon 4 genotypes and alleles in CHD patients with different syndromes"

Group n Genotype frequency [% (cases)] Allele frequency [% (cases)]
E 3/3 E 4/4 E 3/4 E 2/3 E 2/2 E 2/4 ε2 ε3 ε4
PS 20 30.00(6) 5.00(1) 55.00(11) 10.00(2) 0(0) 0(0) 5.00(2) 62.50(25) 32.50(13)
BSS 79 58.23(46) 1.27(1) 25.32(20) 13.92(11) 0(0) 1.27(1) 7.59(12) 77.85(123) 14.57(23)
PBBS 82 48.78(40) 3.66(3) 30.49(25) 15.85(13) 1.22(1) 0(0) 9.14(15) 71.95(118) 18.91(31)
NPNBS 19 31.58(6) 0(0) 57.89(11)* 10.53(2) 0(0) 0(0) 5.26(2) 65.79(25) 28.95(11)
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