ACE活性增加与哮喘、COPD以及COPD共患疾病的发病无关
2009/07/09
血管紧张素转换酶（ACE）基因是哮喘、COPD和COPD共患疾病发病的候选基因之一。本试验在9034名丹麦成人中，研究ACE D等位基因纯合子或杂合子，与ACE II纯合子个体相比，是否具有较高的哮喘、COPD和COPD共患疾病的发病风险。
在普通人群中，血清ACE活性随着D等位基因数量的增加而升高（Kruskal-Wallis ANOVA：II vs. ID, P<0.001；ID vs. DD，P <0.001）；然而在哮喘和COPD中未见该相关性。与ACE II个体相比，普通人群发生哮喘的OR（95％可信区间）在ID个体和DD个体中分别为1.2（0.9-1.4）和1.2（0.9-1.5）；发生COPD的OR在ID个体和DD个体中分别为0.9（0.8-1.1）和1.0（0.8-1.2）。与ACE II个体相比，COPD患者发生缺血性心脏病的OR在ID个体和DD个体中分别为1.1（0.8-1.6）和1.2（0.8-1.7）；发生高血压的OR分别为1.1（0.7-1.5）和0.8（0.5-1.2）；出现低体力活动的OR比分别为0.9（0.5-1.4）、0.7（0.4-1.2）。在校正性别、年龄、吸烟、体重指数、总胆固醇和ACE抑制剂/血管紧张素II 1型受体阻断剂使用等因素后，结果类似。
上述结果显示，由基因导致的长期ACE活性增加并不是哮喘、COPD以及COPD患者缺血性心脏病、高血压和低体力活动的主要发病危险因素。
（陈欣 审校）
Respir Med. 2009 May 5. [Epub ahead of print]
Elevated ACE activity is not associated with asthma, COPD, and COPD co-morbidity.
Lee J, Nordestgaard BG, Dahl M.
The angiotensin-converting enzyme (ACE) gene is a potential candidate gene for risk of asthma, COPD, and COPD co-morbidity. In 9034 Danish adults, we determined whether individuals homozygous or heterozygous for the ACE D allele are at greater risk of asthma, COPD, or COPD co-morbidity compared with ACE II homozygous individuals. In the general population, serum ACE activity increased with the number of D alleles (Kruskal-Wallis ANOVA: II vs. ID, p<0.001; ID vs. DD, p<0.001); however, this did not translate into altered risk of asthma or COPD. In the general population, the odds ratio (95% confidence interval) for asthma was 1.2 (0.9-1.4) for ID individuals and 1.2 (0.9-1.5) for DD individuals compared with II individuals. In the general population, the odds ratio for COPD was 0.9 (0.8-1.1) for ID individuals and 1.0 (0.8-1.2) for DD individuals compared with II individuals. Among patients with COPD, the odds ratio for ischemic heart disease was 1.1 (0.8-1.6) for ID individuals and 1.2 (0.8-1.7) for DD individuals compared with II individuals; corresponding odds ratios for hypertension were 1.1 (0.7-1.5) and 0.8 (0.5-1.2), and for low physical activity 0.9 (0.5-1.4) and 0.7 (0.4-1.2). The results were similar upon adjustment for sex, age, smoking status, body mass index, total cholesterol, and ACE inhibitor/angiotensin II type 1 receptor blocker use. These data suggest that lifelong genetically elevated ACE activity is not a major risk factor for asthma or COPD, or for ischemic heart disease, hypertension, and low physical activity in COPD patients.
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出生时母体子宫内细菌生长与新生儿15～17岁时发生哮喘及过敏性疾病之间的关系
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瘦素是否对肥胖-哮喘相关性起作用
