近35年傣族心血管疾病变化与遗传及环境的作用机制研究

Dai is one unique minority residents in Yunnan Province. Since the seventies of the last century, the applicant of this project has been engaged in the prevention and control of diseases and genetic studies in Yunnan Dai people. In last thirty years, the prevalence of cardiovascular diseases, especially hypertension in Dai people, has been significantly increased several times. The preliminary epidemiological studies found that the increased prevalence might be associated with diet change, intake of fat and salt in Dai people. Based on two Dai people rural settlements in Yunnan, Dehong Dai and Jingpo autonomous prefecture, and Xishuangbanna Dai autonomous prefecture, this study proposes to investigate Dai groups by tracking back their data from 1979, and combining environmental factors with molecular genetics. We propose a "threshold hypothesis" for Dai peoples' significant increase of hypertension, and plan to verify the hypothesis by designed experiments on screening susceptible genes and epigenetic factors of hypertension in Dai peoples. To reveal the mechanism of less stroke in hypertensive patients in Dai people, susceptible and protective genes will be identified by carrying out case-control studies. Preliminary studies show that Dai people is a typical subject in study of hypertension susceptibility. This study will investigate the change of cardiovascular diseases of last 35 years in Dai people, study the interactive mechanism between genetic and environmental factors, and provide scientific reference for prevention and treatment of cardiovascular disease in Dai people.

傣族是云南省特有的少数民族，本项目申请者从上世纪七十年代至今一直从事云南傣族群体的疾病防治和遗传研究。近三十多年，傣族以高血压为主的心血管疾病患病率呈数倍显著增加。本项目通过前期流行病研究发现与近三十多年傣族膳食改变，脂肪和钠盐摄入增加有关。本研究一直立足于云南省德宏州芒市遮放和西双版纳州勐海县勐遮两个固定傣族聚居乡，追踪从1979年至今调查的农村傣族群体，将环境因素与分子遗传学结合，对傣族群体急剧增高的高血压等心血管疾病，提出"阈值假说"，实验设计从傣族群体高血压易感基因、傣族群体高血压表观遗传研究来验证假说。对于傣族高血压患者较少发生脑卒中的问题，开展病例对照脑卒中易感和保护基因研究。前期研究证明，傣族群体是研究高血压易感性的典型对象。本研究探讨近35年傣族心血管疾病变化，研究疾病与遗传及环境的相互作用机制，对于傣族群体心血管疾病提供预防治疗的科学依据。

[近35年傣族心血管疾病变化与遗传及环境的作用机制研究 ]，由中国医学科学院医学生物学研究所与云南省第二人民医院西双版纳州人民医院共同承担。并得到云南省德宏州人民医院的合作。 . 研究基本按照原计划顺利执行完成。 .一、高血压扩大现场调查规模和获取样本，获得傣族高血压患病率。. 总计在德宏州和西双版纳州的乡村地区进行了十一次乡村调查。调查傣族八千多人，收集了2982份血样，包括身高，体重、血压、颈动脉超声、心电图等信息，以及二十多个血液尿液指标。 以此来确定傣族群体高血压的患病率并与周围民族相比较。结果证实傣族高血压发病率近二十多年显著增高。 .二、高血压易感基因的研究。 对800例傣族高血压和924例傣族正常对照 验证GWAS相关SNPs共57个。 后半部分工作，采用了新的技术DNA池全基因组重测序进行分析。.三、对傣族膳食结构的调查， 共选择4个调查点入户180户，调查人群约1000人。研究结论，傣族膳食钠摄入近年来显著增高。.四、傣族脑卒中的研究。本研究组对重度高血压（3级）211人进行了监测， 给予了药物进行干预治疗。 4年的观察高危组未再有脑卒中病例发生。. .本项目已发表SCI论文1篇，核心期刊论文4篇。在投SCI论文2篇。.项目培养1名博士、2名硕士研究生，形成研究机构、地方医院及民族村寨固定点长期队列研究工作结构。