摘要
目的探讨青海地区藏族男性饮酒行为模式及乙醛脱氢酶2(ALDH2)与乙醇脱氢酶3(ADH3)基因多态型分布。
方法(1)现场流行病学调查用于收集研究对象的饮酒行为。在青海省疾病预防控制中心及青海省藏医院的体检人群中,提前找出在当天体检的所有藏族男性,然后每隔一个体检号进行抽样。在青海大学医学院藏医系,以年级分层后采用整群抽样的方法抽取各班同学,被抽取班级的全部男同学进行调查。排除不愿意参与调查的人群。汉族抽取方法如上。所有被抽取的调查者均表示愿意参与该项目方可调查。三个采样点共抽取758人,剔除资料不完整者26份,实际分析资料640份,调查对象年龄为39.7±14.6。其中藏族430人,汉族302人,均为男性。(2)采用血液基因组DNA提取系统试剂盒提取DNA,聚合酶链式反应-限制性片段长度多态型(PCR-RFLP)方法对乙醇脱氢酶3(ADH3)和乙醛脱氢酶2(ALDH2)基因多态型进行检测。
结果(1)藏、汉族的整体饮酒率分别为66.47%和69.54%；藏、汉族人群中安全饮酒者分别占39.07%和41.39%,危险饮酒者分别占27.67%和28.16%；藏、汉族均以低度白酒为主分别占67.94%和64.28%；藏、汉族饮酒者中饮酒方式以众饮佐菜为主分别占79.44%和58.09%,其次为众饮不佐菜分别占12.89%和19.05%,差异有统计学意义(p<0.01)；藏、汉族饮酒人群中认为饮酒是一种交友方式的分别57.49%和51.43%,其次是认为饮酒是一种享受的分别占27.87%和19.05%,差异有统计学意义(p<0.01)；饮酒者脸红是发展成为危险饮酒者的保护因素,吸烟和身边人饮酒是危险饮酒者的危险因素。(2)藏、汉族ADH3*2等位基因频率分别占0.08和0.14,ALDH2*2等位基因的分别占0.22和0.19,ADH3*2和ALDH2*2等位基因在藏、汉族分布差异有统计学意义(p<50.01)；藏族男性中组合基因型分布以野生纯合性ADH3和ALDH2占优势为50%,其次是正常性ADH3和缺陷型ALDH2基因组合型、缺陷型ADH3和正常性ALDH2和缺陷性ADH3和ALDH2基因组合型分别占35.11%、10.46%和4.41%。(3)藏族饮酒行为与ADH3、ALDH2基因相关,与ALDH2基因的更为密切。
结论藏族男性的饮酒率高,饮酒者年轻化,饮酒人群中仍存在不安全饮酒行为。藏族饮酒行为与ADH3、ALDH2基因具有相关性,与ALDH2基因的相关性更为密切。与汉族人群相比,藏族人群中ADH3*1和ALDH2*2占优势,表明藏族饮酒者酒后不良反应较汉族饮酒者多。藏族男性中以功能正常性ADH3和ALDH2基因组合型占优势,该类人群较其他基因组合型饮酒者更易发展成为酗酒者。同时有35.11%的人以正常型ADH3和缺陷型ALDH2基因组合型为主,该人群如果继续饮酒则对机体的损害将更为严重。健康工作者更加需要注意那些处于危险边缘的危险饮酒者和有害饮酒者,如果该危险饮酒者和有害饮酒者还没有发展到酒依赖的程度,能够早期及时的采取干预,能够有效的减少酒量和酒精所致的问题。
Objective To investigate the alcohol behavior pattern and the genetic polymorphism of ADH3and ALDH2among Qinghai male Tibetan.
Methods (1)Data concerning alcohol behavior was obtained by questionnaire. The survey is planed to arranged to the physical examination people healthy testing population in Centers for Disease Control and Prevention and Traditional Tibetan Hospital in QingHai province and procedures are followings:firstly, pick out male tibetan from all people who do their physical test, and then sample one patient every one; The survey is also planed to arranged to students in medical college of QingHai university, all of the boys in the class, which should be sampled in the way of cluster sample, should be investigated, excluding those who don't want take part in the survey; So does the Han nationalism. All of those objects should be willing to participate in this survey. This survey include758persons from three sample sites, ages ranges of39.7±14.6,640files for survey analysis excluding26persons whose personal data is imperfect,430male for tibetan and302for han.
(2) polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique was used to detect the genotype of ADH3and ALDH2.
Results (1)The alcohol drinking rate in Tibetan and Han are66.47%and69.54%respectively; and the safe drinking rate in Tibetan and Han are27.67%and28,16%;the hazardous and harmful drinking are20.21%and28.57%respectively,67.94%liquor is low-alcohol in Tibetan and64.28%for Han. The mainly drinking way are drinking together with dining in Tibetan and Han,and the ratio are79.44%and58.09%.respectively,the drinking together without dining is second.and12.89%and19.05%respectively. There is significant in drinking way(p<0.01), and so did reason of drinking, Most of the drinkers, both Tibetan and Han believe the drinking is the way to make friends, and the ratio are57.49%and51.34%respectively, then consider it is a kind of enjoyment, and27.87%and19.05%respectively. Logistics regression showed the blushing is protective factor, smoking and participate are risk factors to drinking.(2)The allele frequency of ADH3*2among Tibetan(0.08) is significantly lower than that for Han(0.14), while The allele frequency of ALDH2*2among Tibetan(0.22) is significantly higher than that for Han(0.18).The combination genotype is50%with normal ADH3and ALDH2, the normal ADH3mutant ALDH2is35.11%, mutant ADH3normal ALDH2is10.46%, and then mutant ADH3and ALDH2is4.41%.(3) ADH3and ALDH2are associated with drinking behavior in Tibetan male population, and especially with ALDH2.
Conclusions The alcohol rate in male Tibetan is high and the drinkers are younger, there is unsafe behavior in the drinkers. The drinking behavior in Tibetan male were influenced by the genotype of ADH3and ALDH2, especially the genotype of ALDH2.compare to the Han, the frequencies of allele ADH3*1and ALDH2*2in Tibetan male are much higher than Han. It means there are more uncomfortable feeling after drinking in Tibetan than that of Han. The main genotypes are normal ADH3and ALDH2in Tibetan, and the population are higher risk to be alcoholic compare with the other genotype if they are drinking. And there are35.11%population with nomal ADH3and mutant ALDH2genotype which will be more sensitive to drinking alcohol. Health workers pay more attention to the risk drinkers, if they are dangerous drinkers or harmful drinkers and not developed to be the alcoholism, the intervention should be take immediately, it can effectively reduce the alcohol consumption and the alcohol-related problems.
引文
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