血脂异常人群PPAR2基因多态性对复配式粗杂粮膳食干预效果影响
Impact of peroxide-activated receptor gene polymorphism on effects of compound coarse grains dietary intervention among people with dyslipidemia
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摘要: 目的 了解复配式粗杂粮膳食干预对血脂异常人群的影响,探讨过氧化物增值激活受体γ2(PPAR γ2)基因多态性对复配式粗杂粮膳食干预效果的影响,为血脂异常人群制定个体化干预措施提供理论依据。方法 采取多阶段分层整群随机抽样方法对在江苏省南京鼓楼区、白下区、秦淮区抽取911例血脂异常患者,分为复配式粗杂粮膳食干预组(n=445)与对照组(n=466),比较2组人群干预前后形态学指标及血脂变化;采用聚合酶链反应-限制性片段长度多态性方法(PCR-RFLP)对干预组人群进行基因型检测,比较PPARγ2 基因Pro12/Ala12不同基因型对膳食干预的影响。结果 经过1年的复配式营养干预,干预组人群体质指数(BMI)和腰臀比(WHR)从(25.22±3.28) kg/m2和(0.89±0.60)下降到(24.91±2.95) kg/m2和(0.88±0.09),血清总胆固醇(TC)、甘油三酯(TG)和高密度脂蛋白胆固醇(HDL-C)从(5.38±1.02)、(2.35±1.48)、(1.21±0.49) mmol/L下降到(4.80±0.91)、(1.72±1.14)、(1.35±0.39) mmol/L(均P<0.05);干预组的降脂有效率为91.70%,高于对照组有效率的15.45%,差异有统计学意义(χ2=503.7,P<0.001);干预组血脂异常人群中PPARγ2 基因Pro12/Ala12 3种基因型中以PP基因型为主,其次为PA型和AA型,分别占89.21%、10.34%和0.45%;PP型人群干预后BMI、WHR、TC、TG水平均低于干预前,HDL-C水平高于干预前(均P<0.05),PA型人群干预后TC、TG水平均低于干预前,HDL-C水平高于干预前(均P<0.05);与PP型人群比较,PA型人群TC水平下降幅度较大(t=-2.134,P=0.033)。结论 复配式粗杂粮有改善脂代谢紊乱的作用,血脂异常人群中PPARγ2 基因Pro12/Ala12不同基因型以PA型人群对复配式营养干预最敏感。Abstract: Objective To evaluate the effects of multiple nutritional dietary intervention on serum lipid profiles and physical indexes in a hyperlipidemia population and to study the relationship between peroxisome proliferator-activated receptor γ2(PPARγ2)Pro12/Ala12 genetic polymorphism and multiplex nutritional dietary intervention for making individual measures of hyperlipidemia prevention.Methods Totally 911 community adults(aged ≥45 years)with hyperlipidemia were recruited from Nanjing city and assigned into an intervention group(n=445)and a control group(n=466)and the participants in the intervention group were administered a compound nutritional intervention.The genotypes of PPARγ2 Pro12/Ala12 of the intervention group were determined with polymerase chain reaction-restriction fragment length polymorphism(PCR-RELP)technique and the susceptibilities to the intervention of the participants were compared.Results For the participants of the intervention group,both body mass index(BMI)and waist-hip ratio(WHR)decreased distinctly and blood lipid profiles were obviously improved compared to those of at the beginning of the intervention and those of the control group after the one-year compound nutritional intervention(all P<0.05).The lipid-lowering efficacy rate of the intervention group was 91.70%(408/445)and that of the control group was 15.45%(72/466),with a statistically significant difference(P<0.001).Among the participants in the intervention group,the proportions of PPARγ2 Pro12/Ala12 genotype were 89.21%(397/445)for PP,10.34%(46/445) for PA,and 0.45%(2/445) for AA.The hyperlipemia individuals with PA genotype were more susceptive to the dietary intervention than those with PP genotype and the total cholesterol in the participants with Ala12/X genotype decreased significantly(P<0.05).Conclusion The results show that multiplex dietary intervention can improve BMI,WHR,blood lipid profiles,blood glucose,and blood pressure in hyperlipidemia population.Analysis of genetic polymorphism suggests that different PPAR γ2 genotypes have different impacts on the effects of coarse grain dietary intervention in hyperlipidemia population.
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