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目的探讨β2肾上腺素能受体(β2-AR)Arg16Gly基因多态性及与职业精神紧张的交互作用对原发性高血压(EH)发生的影响。方法以职业紧张高暴露的男性行车人群为基础的1∶1病例对照研究(95对),调查职业紧张、紧张反应、焦虑、A型行为等职业精神紧张及高血压的常见危险因素,应用PCR-RFLP技术检测β2-ARArg16Gly基因多态性。采用似然比检验判断因素效应之间是否有相乘模型OR交互=OR11/(OR01×OR10)的交互作用。结果病例组和对照组的β2-AR16位点基因Arg/Arg、Arg/Gly、Gly/Gly频率分布有差异,具有统计学意义(P<0.05),在调整BMI等影响因素后,携带Gly/Gly的个体患EH的OR值为2.759(95%CI:1.200～6.347);携带突变型Arg16Gly基因与紧张反应、特质焦虑对原发性高血压影响的交互作用符合相乘模型,当携带突变型Arg16Gly基因与高紧张反应、特质焦虑同时存在时,其患EH的风险分别增加至12.797(95%CI:3.379～48.461),40.862(95%CI:1.403～119.057)。结论β2-AR基因Arg16Gly多态性很可能是职业紧张高暴露男性行车人群EH发生的重要易感因素;携带突变型Arg16Gly基因的个体,暴露于紧张反应和特质焦虑时,其原发性高血压发生的危险性显著增加。
Objective To investigate the effect of the Arg16Gly polymorphism of β2-adrenergic receptor (β2-AR) and the interaction with occupational stress on essential hypertension (EH). Methods One-to-one case-control study (95 pairs) based on the male driving population exposed to high occupational stress was used to investigate the common risk factors of occupational stress and hypertension such as occupational stress, nervousness reaction, anxiety and type A behavior. -RFLP assay for β2-ARArg16Gly gene polymorphism. The likelihood ratio test is used to determine whether there is a multiplicative model OR interaction between the effectors = OR11 / (OR01 × OR10). Results There were significant differences in the frequency distribution of Arg / Arg, Arg / Gly and Gly / Gly between β2-AR16 locus and control group (P <0.05). After adjusting for the influence of BMI and other factors, The odds ratio (OR) of individuals with Gly with EH was 2.759 (95% CI: 1.200 ~ 6.347). The interaction between mutation-tolerant Arg16Gly gene and stress reaction and trait anxiety on essential hypertension was consistent with multiplicative model. Arg16Gly increased risk of EH to 12.797 (95% CI: 3.379-48.461) and 40.862 (95% CI: 1.403-119.057), respectively, in combination with high-stress and idiosyncratic anxiety. Conclusion The Arg16Gly polymorphism of β2-AR gene is likely to be an important predisposing factor for EH occurrence in high-occupational driving stress-exposed male drivers. Individuals carrying the mutant Arg16Gly gene, exposed to stress and trait anxiety, The risk of occurrence is significantly increased.