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[目的]探讨血管紧张素Ⅱ1型受体(angiotensin II type I receptor,AT1R)、血管紧张素原(angiotensinogen,AGT)基因多态性与肾功能等临床指标的关系。[方法]多阶段随机抽取2 026例上海市浦东新区20~80岁的社区居民为研究对象,排除服用降压药、降脂药和有亲缘关系者。收集人口学资料和生活方式等信息;测量身高、体重;检测血肌酐、尿肌酐及尿微量白蛋白等指标;计算尿白蛋白/肌酐比值(albumin-to-creatinine ratio,ACR)和肾小球滤过率(estimated glomerular filtration rate,eGFR);应用聚合酶链-高温连接酶连接检测技术(PCR-LDR)检测基因多态性。[结果]2 026例成年人群中,AT1R A1166C和AGT rs699不同基因型在性别构成、年龄均值及吸烟和饮酒的比例上差异均无统计学意义(P>0.05)。所有研究对象按性别分层,上述位点尿肌酐、尿白蛋白、血肌酐、ACR、eGFR均值,及白蛋白尿和肾功能下降的比例两类基因型间差异均无统计学意义(P>0.05);按年龄分层,45岁及以上人群AT1R A1166C AA基因型的eGFR均值低于AC/CC基因型,差异有统计学意义(P<0.05)。logistic回归分析结果未发现基因型与白蛋白尿或肾功能下降有关联。广义线性模型分析结果也未发现两种突变等位基因携带之间的交互效应(P>0.05);以eGFR为应变量时,AT1R A1166C C等位基因携带与年龄组间交互项有统计学意义(P=0.039),进一步按年龄组分层,AA与AC/CC之间差异无统计学意义(P>0.05)。[结论]对于所有对象,未发现AT1R A1166C和AGT rs699多态性与肾功能指标的统计学关联,而中老年人群AT1R A1166C C等位基因突变与eGFR增高有统计上的关联。
[Objective] To investigate the relationship between angiotensin Ⅱ type I receptor (AT1R), angiotensinogen (AGT) gene polymorphism and clinical features such as renal function. [Method] A total of 2 026 community residents from 20 to 80 years old in Pudong New Area of Shanghai were randomly selected from multiple stages as research object, excluding antihypertensive drugs, lipid-lowering drugs and related persons. Collect demographic information and lifestyle information; measure height and weight; measure serum creatinine, urinary creatinine and urinary microalbumin; calculate the albumin-to-creatinine ratio (ACR) and glomerular The estimated glomerular filtration rate (eGFR) was determined by polymerase chain reaction-polymerase chain reaction-polymerase chain reaction (PCR-LDR). [Results] The genotypes of AT1R A1166C and AGT rs699 in 2 026 adult population showed no significant difference in gender, age, smoking and alcohol consumption (P> 0.05). All subjects stratified by sex, there was no significant difference between the two genotypes of urinary creatinine, urinary albumin, serum creatinine, ACR, eGFR and albuminuria and renal function decline in the above sites (P> 0.05). According to age stratification, the mean eGFR of AT1R A1166C AA genotype in people aged 45 years and above was lower than that in AC / CC genotype (P <0.05). Logistic regression analysis did not find genotype associated with albuminuria or decreased renal function. The generalized linear model analysis also found no interaction between the two mutant alleles (P> 0.05). When eGFR was taken as a response variable, the interaction between AT1R A1166C C allele and age group was statistically significant (P = 0.039). There was no significant difference between AA and AC / CC by age group (P> 0.05). [Conclusion] No statistical association was found between AT1R A1166C and AGT rs699 polymorphisms and renal function indexes for all the subjects, whereas the AT1R A1166C C allele mutation was associated with a statistically significant increase in eGFR in the elderly population.