Interaction of gene polymorphism with body mass index and alcohol consumption on the prognosis of Uyghur patients with ischemic heart failure.

Objectives: To investigate the interaction of gene polymorphism with body mass index (BMI) and alcohol consumption on the prognosis of Uyghur patients with ischemic heart failure (IHF).

Methods: A total of 205 Uyghur patients with IHF admitted in Urumqi Friendship Hospital from June 2014 to June 2017 were enrolled; 200 age and sex-matched healthy Uyghur physical examiners in the hospital were enrolled as healthy controls. The gene +1267 polymorphism was detected by PCR. Multivariate unconditional logistic regression was used to analyze the risk factors associated with prognosis in patients with IHF, and the relative excess risk of interaction (RERI) was calculated by crossover analysis to determine the interaction of gene polymorphism with BMI and alcohol consumption.

Results: Patients were followed up for 3 years, there were 56 cases with poor prognosis (27.32%) and 149 cases with good prognosis (72.68%). Compared with the healthy control group and the good prognosis group, the poor prognosis group had a significantly higher proportion of subjects with alcohol consumption, abnormal alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels as well as lower BMI and left ventricular ejection fraction (all <0.05). There were significant differences in distributions of genotype AA/AG/GG and A/G allele between the good prognosis group and the poor prognosis group (both <0.05). There were significant differences in the distribution of genotype (=45.42, <0.01) and A/G allele among IHF patients with different NYHA cardiac function class; the frequency of A allele of gene increased, and G allele decreased with the increase of cardiac function class (=19.14, <0.01). Multivariate logistic regression analysis showed that alcohol consumption as well as abnormal ALT and AST were risk factors for poor prognosis in patients with IHF, while BMI and GG type of gene (compared with AA type) were protective factors (all <0.05). Crossover analysis showed a significant additive interaction between BMI and gene polymorphism (=1.15, 95% 0.54-1.76, <0.01), and for patients carrying - gene type AA/AG, BMI<26.5 kg/m increased the risk of poor prognosis (=7.47, 95%: 2.51-22.22, <0.01); there was no significant additive interaction between alcohol consumption and gene polymorphism (=0.56, 95%: －6.07-7.20, >0.05).

Conclusions: The gene polymorphism interacts with BMI in Uyghur IHF patients, and BMI<26.5 kg/m increases the risk of poor prognosis in IHF patients carrying the AA/AG genotype.