Hipertansif hastaların ailelerinde Apo E gen polimorfizmleri ve kan lipit profillerinin değerlendirilmesi
Hipertansif hastaların ailelerinde Apo E gen polimorfizmleri ve kan lipit profillerinin değerlendirilmesi
Yazar: Doğan, Abdullah; Yenicesu, Cem; Sucaklı, Mustafa; Özdemir, Öztürk; Demirel, Yeltekin
Dergi: Cumhuriyet Tıp Dergisi, Vol. 36 No. 4, 2012
Anahtar kelimeler: Hypertension, lipid profile, genetic predisposition ; Hipertansiyon, lipid profili, genetik yatkınlık

ÖzetAmaç. Bu çalışmamızda, hipertansif hastaların ailelerinde Apo E gen polimorfizmleri ve kan lipit profillerinin değerlendirilmesi amaçlanmıştır. Yöntem. Çalışmamız iki aşamada planlandı. İlk aşamada; 45 yaş altı popülasyonda CVD (CardiovascularDisease) gen mutasyonunu değerlendirmek için, esansiyel hipertansiyona sahip 50 kişilik olgu grubu ve aynı yaş grubu ve cinsiyette tansiyonu normal sınırlarda olan 50 kişilik kontrol grubu seçildi. Çalışmanın ikinci aşamasında, olgu grubundaki ACE gen polimorfizmi DD homozigot olan hastaların birinci derece akrabalarında (50), genetik polimorfizm açısından değerlendirildi. Bulgular. Olgu grubunda ApoE3/E4 alleline sahip olanların %88,9’unda ailede hipertansiyon hikayesi mevcuidi. Aynı şekilde E3/E2 genotipine sahip olanların hepsinde aile hikayesi pozitif idi. Olgu grubunda, 5 kişide (%10) ApoE E3/E2 gen polimorfizmi, 9 kişide (%18) ApoE E3/E4 gen polimorfizmi mevcuttu. Kontrol grubunda bu sayılar sırasıyla 7 ve 3 (%14 ve %6) idi. Olgu grubunda ApoE3/E2 gen polimorfizmi, kontrol grubundan daha yüksekti (p>0,05). Olgu grubunda E3/E4 genotipi, kontrol grubundan yüksekti; ancak bu istatiksel olarak anlamlı bulunmadı. Total kolesterolü 200 mg/dL ve üzeri olanların %62,5’i olgu grubundaydı ve bu oran, kontrol grubuna göre (%37,5) istatistiksel olarak anlamlı şekilde yüksekti (p<0,05). Aile grubunda bu oran %66 idi. HDL ortalama değerleri 3 grupta da düşüktü (olgu grubunda 41,93 ± 11,22 mg/dL, aile grubunda 40,4 ± 13,4 ve kontrol grubunda 44,93 ± 15,24 mg/dL). Olgu grubunda LDL ortalaması 133,6 ± 32,2 mg/dL, aile grubunda 137,8±30,8 mg/dL ve kontrol grubunda 123,4 ± 32,9 mg/dL olarak belirlendi. Total kolesterol/HDL kolesterol oranı; olgu grubunda 4,9 ± 1,4, aile grubunda 5,7 ± 2,3 ve kontrol grubunda 4,7 ± 1,8 idi. Aile grubunda hipertansiyon prevalansı %56 idi (45 yaş ve altı bireylerde %37). 40 yaş öncesi hipertansiyon tanısı alanların oranı %42,9 idi. Sonuç. Hem olgu hem de aile grubunda kolesterol, LDL değerleri ve total kolesterol/HDL oranının yüksek, HDL değerlerinin düşük olması için gerekli hayat tarzı değişikliklerinin yapılması gerektiğini düşündürmektedir. Sonuç olarak, hipertansiyon etiyolojisi sorgulanırken, genetik faktörler de göz önünde tutulmalıdır ve hipertansiyondan sorumlu tutulan genlerle ilgili çalışmalar yapılmalıdır. Ayrıca hipertansif hastalar değerlendirilirken tüm aile bireylerinin taranması yapılarak, hipertansiyon ve diğer kardiyovasküler hastalıklar açısından takip edilmelidir. Özellikle 40 yaş öncesi hipertansiyon tanısı konmuş olan hastalar ve ailesi hem genetik açıdan, hem de diğer risk faktörleri (VKİ, lipid profili, sigara, alkol) açısından takip edilmeli ve hayat tarzı değişikliklerinin uygulanması sağlanmalıdır.Anahtar sözcükler: Hipertansiyon, lipid profili, genetik yatkınlık AbstractAim. It is observed in studies that hypertension is a feature of familial and a variety of gene polymorphism is associated with hypertension. Method. This study was planned in two stages.At the first stage; to evaluate gene mutation, in population under the age of 45 CVD (CardiovascularDisease) case group of 50 persons with essential hypertension and at the same age group and sex, within normal blood pressure limits in a control group of 50 people was selected.In the second stage, cases of first-degree relatives of patients with homozygous polimorfizm DD ACE gene group (parents and siblings) family group of 50 people, were evaluated for genetic polymorphism. Results. Those with cases of allele ApoE3/E4 group, 88.9% had a family history of hypertension. In the same way, in all of those with the E3/E2 genotype, family history was positive. In the case group, 5 people (10%) E3/E2 ApoE gene polymorphism, 9 patients (18%) had APOE E3/E4 gene polymorphism. In the control group, these numbers was about respectively, 7, and 3 (14% and 6%).In the control group, ApoE3/E2 gene polymorphism, higher than control group (p>0.05). Case group E3/E4 genotype, higher than the control group; but this difference was not statistically significant. Total cholesterol 200 mg/dL and above those 62.5% of people were in the case group and this ratio compared to control group (37.5%) were significantly higher (p<0.05). In the family group, this rate was 66%. The mean values of HDL was lower in the 3 groups (case group, 41.9 ± 11.2, family group, 40.4 ± 13.4 and control group 44.9 ± 15:24 mg/dL).Mean LDL values were determined as 133.6 ± 32.2 mg /dL in case group, 137.8 ± 30.8 mg/dL in family group, and 123.4 ± 32.9 mg /dL in control group. Total cholesterol/HDL cholesterol ratios were 4978 ± 1.41 in case group, 5.7 ± 2.3 in family group and 4670 ± 1.83 in control group. The prevalence of hypertension was 56% in family group, (37% in individuals 45 years and under). 42.9% of those diagnosed before the age of 40 had hypertension. Conclusion. Both the case and the family group, cholesterol, LDL levels and total cholesterol/HDL ratio is high, low HDL levels, lipid values should be within normal limits suggests that lifestyle changes are necessary to bring. As a result, while the etiology of hypertension is querying, also genetic factors should be considered in, and studies on genes and hypertension should be held responsible.In addition, hypertensive patients should be monitorized for hypertension and other cardiovascular diseases by screening of all family members while they are being evaluated. Especially patients with hypertension was diagnosed before the age of 40 and their families should be monitored for both genetic and other risk factors (BMI, lipid profile, smoking, alcohol). Lifestyle changes which are important for hypertension prevention and control of hypertension should be employed.Keywords: Hypertension, lipid profile, genetic predisposition

Aim. It is observed in studies that hypertension is a feature of familial and a variety of gene polymorphism is associated with hypertension. Method. This study was planned in two stages.At the first stage; to evaluate gene mutation, in population under the age of 45 CVD (CardiovascularDisease) case group of 50 persons with essential hypertension and at the same age group and sex, within normal blood pressure limits in a control group of 50 people was selected.In the second stage, cases of first-degree relatives of patients with homozygous polimorfizm DD ACE gene group (parents and siblings) family group of 50 people, were evaluated for genetic polymorphism. Results. Those with cases of allele ApoE3/E4 group, 88.9% had a family history of hypertension. In the same way, in all of those with the E3/E2 genotype, family history was positive. In the case group, 5 people (10%) E3/E2 ApoE gene polymorphism, 9 patients (18%) had APOE E3/E4 gene polymorphism. In the control group, these numbers was about respectively, 7, and 3 (14% and 6%).In the control group, ApoE3/E2 gene polymorphism, higher than control group (p>0.05). Case group E3/E4 genotype, higher than the control group; but this difference was not statistically significant. Total cholesterol 200 mg/dL and above those 62.5% of people were in the case group and this ratio compared to control group (37.5%) were significantly higher (p