Association between angiotensin converting enzyme gene polymorphisms and left ventricular hypertrophy in children and adolescents with essential hypertension
10.3760/cma.j.cn101070-20240205-00075
- VernacularTitle:血管紧张素转换酶基因多态性与儿童青少年原发性高血压左心室肥厚的相关性研究
- Author:
Chen SHEN
1
;
Hui WANG
;
Yao LIN
;
Yuting WANG
;
Yanyan LIU
;
Lin SHI
Author Information
1. 首都儿科研究所，北京 100020
- Keywords:
Essential hypertension;
Angiotensin converting enzyme;
Gene polymorphism;
Left ventricular hypertrophy;
Child;
Adolescent
- From:
Chinese Journal of Applied Clinical Pediatrics
2024;39(9):660-665
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To examine the distribution features of angiotensin converting enzyme ( ACE) gene I/D polymorphisms and their correlation with left ventricular hypertrophy (LVH) in children and adolescents with essential hypertension. Methods:This was a case-control study.One hundred and forty-four children and adolescents who were diagnosed with essential hypertension but received no treatment at the Department of Cardiology, Children′s Hospital, Capital Institute of Pediatrics from January 2022 to April 2023 were recruited. ACE gene polymorphisms were detected using the polymerase chain reaction-restriction fragment length polymorphism method.Patients were divided into the DD+ DI genotype group and the II genotype group according to the dominant model, and the differences in gene frequencies, genotype frequencies, clinical data, and plasma renin-angiotensin-aldosterone system (RAAS) levels were compared between the two groups.In addition, according to the echocardiographic findings, patients were divided into the LVH and non-LVH groups.The risk factors of LVH were analyzed using the multivariate Logistic regression model.The correlation of ACE gene I/D polymorphisms with LVH in children and adolescents with essential hypertension was evaluated using the Spearman analysis.The correlation between plasma RAAS levels and LVH was assessed using the partial correlation analysis. Results:The frequencies of DD, DI and II genotypes in 144 patients were 11.1%, 50.7% and 38.2%, respectively.The frequency of the D and I allele was 36.5%(105/288) and 63.5%(183/288) respectively.Patients in the DD+ DI genotype group (89 cases) were older than those in the II genotype group (55 cases) ( Z=-2.308, P=0.021), and there was no statistically significant difference between the two groups in gender and height (all P>0.05).The incidence of LVH in the DD+ DI genotype group was higher than that in the II genotype group, with a statistically significant difference ( χ2=5.230, P=0.022).Renin activity in RAAS levels was positively correlated with left ventricular mass index and relative wall thickness ( r=0.276, 0.247; P=0.002, 0.006).Multivariate Logistic regression analysis showed that both DD+ DI genotype ( OR=5.678, 95% CI: 1.623-19.872) and body mass index (BMI) ( OR=1.124, 95% CI: 1.024-1.233) were risk factors for the development of LVH in children and adolescents with essential hypertension (all P<0.05). Conclusions:ACE gene I/D polymorphisms are strongly associated with LVH.DD+ DI genotype and BMI are independent risk factors for the development of LVH in children and adolescents with essential hypertension.
