Abstract :
Abstract
Background
The PAI-1 gene promoter 4G/5G polymorphism was found to be associated with plasma PAI-1 activity in white but not yet in Chinese patients. Hypertension might exaggerate the 4G/5G genotype effect on plasma PAI-1.
Methods
The 4G/5G genotypes and plasma PAI-1 levels were determined in 565 Chinese, 211 with and 354 without hypertension to study the genotype effect and the mode of gene–environment interaction.
Results
Hypertensive patients showed significantly higher plasma PAI-1 activity (18.2 ± 10.0 v 14.6 ± 8.8 IU/mL, P< .001) than normotensive subjects, and also higher body mass index (BMI) and plasma triglyceride (TG), but had neither significant difference in the 4G allele frequency (0.531 v 0.549) nor in the 4G/4G genotype percentage (24.6% v 26.5%). The 4G/4G genotypic group had higher plasma PAI-1 activity (17.6 ± 10.2 v 14.5 ± 7.3 IU/mL, P = .027) than the 5G/5G genotypic groups, but the statistic significance was present in women (18.1 ± 10.0 v 14.8 ± 6.9 IU/mL, P = .025) and not in men (17.2 ± 10.5 v 14.3 ± 7.7 IU/mL, P = .39) after log transformation. Multiple regression analysis of all cases documented the independent effect of BMI (P = .000), plasma TG (P = .000), age (P = .006), gender (P = .046), and the PAI-1 genotype (4G/4G v 5G/5G, P = .012) on plasma PAI-1 activity. However, the significant association of 4G/4G genotypes with higher plasma PAI-1 activity was present in women (P = .004) but not in men. There was a significant difference (P = .04) on the plasma TG-PAI-1 activity correlations between the 4G/4G (r = 0.521) and 5G/5G (r = 0.117) genotypic groups of hypertensive patients.
Conclusions
The present study showed that the 4G/4G genotype was associated with elevated plasma PAI-1 activity in Chinese patients with and without hypertension. The contribution of the PAI-1 genotype seemed larger in women. In hypertensives carrying the 4G/4G genotype, higher TG was correlated with higher PAI-1, suggesting a possible contribution of gene–environmental interaction to their high risk for atherothrombotic disease.
