Rabia AKILLI EKER, Çağlar Emre ÇAĞLIYAN, Onur KAYPAKLI, Mehmet KANADAŞI, Mustafa DEMİRTAŞ

Türkiye'nin güneyinde genç hastalarda görülen miyokart enfarktüsü için yeni genetik risk faktörleri

Amaç: Genetik yatkınlık genç hastalarda ateroskleroz gelişiminde önemli rol oynamaktadır. Bu çalışmanın amacı, Çukurova bölgesinde miyokart enfarktüsü geçiren genç hastalarda miyokart enfarktüsü ile HLA antijenleri arasındaki ilişkiyi belirlemektir.Gereç ve Yöntem: Çalışmaya 45 yaşından önce miyokart enfarktüsü geçirmiş 36 erkek ve 55 yaşından önce miyokart enfarktüsü geçirmiş 14 kadın olmak üzere (ort. yaş 45.0±7.1) toplam 50 hasta alındı. Kontrol grubu 50 sağlıklı bireyden (31 erkek, 19 kadın, ort. yaş 51.55.5) oluşturuldu. HLA doku tiplemesi ve trombojenik faktörlerin belirlenmesi için venöz kan örnekleri toplandı. HLA antijenleri (HLA-A,B,C,-DQ,-DR) Polimeraz Zincir Reaksiyonu- Sekans Spesifik Oligonükleotit tiplendirme (PCR-SSO) metodu ile çalışıldı.Bulgular: Hasta ve kontrol grubunda HLA antijenlerinin sıklığı HLA-A24 için %38 ve %10, HLA-DQB2 için %40 ve %10, HLA-DRB1-7 için %26 ve %6 ve HLA-DRB4-1için %52 ve %26 idi. Ki-kare testi hastalıkla ve bu antijenlerin varlığı arasında anlamlı bir ilişki olduğunu ortaya koydu. Lojistik regresyon analizinde sigara kullanımı, Lp(a), homosistein ve HLA-DQB1 alt tipi genç hastalarda MI gelişimi ile bağımsız olarak ilişkiliydi.Sonuç: Çalışma sonuçlarına göre HLA-A24, HLA-DQB2, HLA-DRB1-7 ve HLA-DRB4-1 antijenlerinin Çukurova bölgesinde koroner arter hastalığına eğilimi belirlemede genetik belirteçler olarak kullanılabileceği sonucuna varılmıştır.

Anahtar Kelimeler:

Miyokart enfarktüsü, HLA

New genetic risk factors for myocardial infarction at young patients in Southern Turkey

Purpose: Genetic predisposition plays an important role in the development of atherosclerosis in young patients. The aim of this study was to determine the relationship between myocardial infarction and HLA antigens in young patients who had myocardial infarction in southern region of Turkey. Materials and Methods: We enrolled 50 patients ( 36 male, 14 female, mean age 45.0  7.1 ) who had myocardial infarction before 45 years old in men and 55 years old in women and 50 healthy subjects (31 male, 19 female, mean age 51.5  5.5 ) as a control group into the study. Venous blood samples were collected for HLA tissue typing and determining trombogenic factors. Histocompatibility antigens (HLA-A,B,C,-DQ,-DR) were studied with Polymerase Chain Reaction (PCR)-Sequance Spesific Oligonucleotide typing (SSO) method. Results: Frequency of HLA antigens in patients and controls were 38% and 10% for HLA-A24, 40% and 10% for HLA-DQB2, 26% and 6% for HLA-DRB1-7 and 52% and 26% for HLA-DRB4-1. Chi square test revealed a significant relation with the disease and the presence of these antigens. In the logistic regression analysis, smoking, Lp(a), homocysteine and HLA-DQB1 subtype were independently associated with development of MI in young patients.Conclusion: The presence of HLA-A24, HLA-DQB2, HLA-DRB1-7 and HLA-DRB4-1 may be used as genetic markers for the tendency to coronary artery disease in southern region of Turkey.

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