卫生研究

目的 了解职业慢性心理应激与转氨酶、热休克蛋白70 (heat shock protein70,HSP70)基因家族及其蛋白交互作用与代谢综合征(metabolic syndrome, MS)的关联。方法 采用病例-对照研究，根据纳入排除标准，于2015年3月—2016年3月从吴忠市人民医院和宁夏医科大学总医院住院和体检者中(20～60岁)选取无血缘关系的583名MS患者为病例组，585名对照人群为对照组。进行问卷调查、体格检查、临床以及生化指标检测、血清HSP70水平以及HSP70基因五位点多态性检测。GMDR 0.7软件分析心理应激、转氨酶、HSP70基因及其蛋白交互作用与MS关系。结果 调整年龄、性别后，HSP70基因rs1008438、rs1061581、rs539689及rs222795位点在共显性和显性以及rs222795位点在超显性中野生纯合基因型和杂合基因型均与MS风险降低有关(P<0.05,OR<1)。GMDR分析结果显示，心理应激与血清HSP70组成的2因子交互模型、与转氨酶活性组成的2～3因子交互模型、与HSP70基因五位点组成的2～6因子交互模型，心理应激与转氨酶活性、HSP70基因及其蛋白组成的2～9因子交互模型均与MS显著相关(P<0.01,P<0.05),各全因子交互模型均为最佳，其中9因子最佳交互模型的MS患病风险最高(OR=46.51,95%CI 27.65～78.26),高危型患MS的风险是低危型的45.23倍(95%CI 31.29～65.38,P<0.01)。结论 HSP70基因家族携带野生型等位基因为MS的保护因素。职业慢性心理应激与转氨酶、HSP70基因及其血清蛋白交互作用与MS有关，组成的高危型交互作用模型的患病风险高于低危型模型。

OBJECTIVE To explore the association of Occupational chronic psychological stress with transaminase, heat shock protein70(HSP70)gene family and their protein interaction with metabolic syndrome(MS).METHODS A case-control study was used. According to the inclusion and exclusion criteria, from March 2015 to March 2016, 583 unrelated MS patients were selected as the case group and 585 unrelated healthy people as the control group among hospitalized and physical examination subjects aged 20-60 in Wuzhong People's Hospital and General Hospital of Ningxia Medical University. Questionnaire survey, physical examination, clinical and biochemical indicators, serum HSP70 level and five-locus polymorphism detection of HSP70 gene were carried out. GMDR 0.7 software was used to analyze the relationship between psychological stress, transaminase, HSP70 gene and its protein interaction and MS.RESULTS After adjusting for age and sex, the rs1008438, rs1061581, rs539689 and rs222795 locus of HSP70 gene in the Co-dominant model and Dominant model and the rs222795 loci in the Over-dominant model carry wild homozygous genotype and heterozygous genotype were all related to the reduction of MS risk(OR<1,P<0.05). GMDR result: the 2-factor interaction model composed of psychological stress and serum HSP70, the 2-3 factor interaction model composed of transaminase activity, and the 2-6 factor interaction model composed of five locus of HSP70 gene, the 2-9 factor interaction model consisting of psychological stress and transaminase activity, HSP70 gene and its protein were all significantly associated with MS(P<0.01, P<0.05), all each factor interaction models were the best, and the 9-factor optimal interaction model had the highest risk of MS(OR=46.51,95%CI 27.65-78.26), and the risk of MS in high-risk type was 45.23 times higher than that in low-risk type(95%CI 31.29-65.38,P<0.01).CONCLUSION HSP70 gene family carrying wild-type alleles is a protective factor for MS. The interaction among Occupational chronic psychological stress interacts with transaminases, HSP70 gene and its serum proteins may be associated with MS. With the increase of involvement interaction factors, the risk of MS increased significantly. The interaction of multiple factors can greatly increase its risk.