在台灣人族群中介白素-10 的-592C/A 基因多型性與急性心肌梗塞好發之間的關聯性

急性心肌梗塞在台灣的發生率日趨升高，同時在環境因素與遺傳多型性的交互作用下，好發年齡有下降的趨勢。近來，發炎反應在「斑塊破裂」這個心肌梗塞特有病徵的形成過程中所扮演的角色一直被廣泛討論；一些相關於心肌梗塞過程中之前發炎反應的基因多型性也一直被研究當中。過去的研究也顯示，抗發炎反應機制與前發炎因子間不平衡的發展，結果有利於前發炎因子時，會造成動脈粥狀硬化斑塊破裂。介白素-10（interleukin-10, IL-10）是一種抗發炎反應的細胞激素，許多證據顯示IL-10在動脈粥狀硬化形成過程中具有保護作用。同時在許多的流行病學危險因子當中，肥胖被深信與高血壓、心血管疾病、糖尿病以及心肌梗塞等疾病有重要的相關性。為了釐清肥胖以及IL-10與心肌梗塞好發性之間的關係，因此我們選定125位急性心肌梗塞的患者以及234位非相關的健康對照組進行病例-控制試驗，其中98位無任何心肌梗塞病史，但仍不排除有其它心血管疾病徵狀者作為對照組ПA；136位不具有傳統心血管疾病危險因子者，作為對照組ПB。利用PCR-RFLP的方法來探討IL-10 -592C/A基因多型性與台灣人族群中之心肌梗塞好發之間的關係。結果顯示急性心肌梗塞患者之IL-10-592 A/A基因型與對照組ПA之間具有統計意義（p=0.009），但與對照組ПB並無明顯差異（p=0.236）。另外，IL-10-592基因多型性在肥胖者與急性心肌梗塞病患間也沒有明顯差異（p=0.111）。因此，我們認為台灣人族群中具有心血管疾病危險因子者，其IL-10-592 C/A基因多型性與急性心肌梗塞之好發有關，但此基因多型性在肥胖病患中與急性心肌梗塞之好發性則無直接關係。

High prevalence of acute myocardial infarction (AMI) among Taiwanese cohort, and the age of illness onset is descend to younger age due to the interplay between environmental risk factors and genetic polymorphisms. Recently, the inflammation was widely discussed its importance to develop the plaque ruptures, the crucial feature of myocardial infarction. The gene polymorphisms contributed to pro-inflammation processes of infracted heart were also intensively investigated. Previous data showed the imbalance between anti-inflammatory mechanisms and pro-inflammatory factors resulted in rupture of atherosclerotic plaque. Interleukin-10 (IL-10) is a cytokine with anti-inflammatory and evidence suggests a potential protective role for IL-10 in atherosclerosis. Among several etiological risk factors, obesity was associated with hypertension, cardiac disease, diabetes and myocardial infarction. For discriminating the association between obesity , IL-10 polymorphism and the onset of AMI. Therefore, we conducted a case-control study of 125AMI patients vs. 234 unrelated normal subjects in order to investigate the association of the -592C/A polymorphisms of IL-10, to the onset of AMI among Taiwanese cohort. Among the control subjects 98 apparently healthy individuals who have no AMI disease history but still can not rule out others cardiovascular symptoms were recruited as control group ПA and 136 personnel who have no conventional cardiovascular disease risk factors were also defined as control group ПB. IL-10-592C/A polymorphism was genotyped by PCR-RFLP. An association of the IL-10-592A/A genotype of control group ПA to the AMI onset was found (p=0.09), but not in control group ПB (p=0.236). In addition, there was no differences of IL-10 C-592A polymorphism in patient with AMI and obesity (p=0.111). In conclusions, our results suggest that IL-10-592C/A polymorphism was associated with acute myocardial infarction among Taiwanese cohort with conventional cardiovascular disease risk factors and this polymorphism was not associated with AMI in obesity patients.