
Contribution of <i>AGTR</i> 1 Promoter Region Polymorphism to the Progression and Outcome of Sepsis in Patients with Various Comorbidities
Author(s) -
А. Г. Чумаченко,
Е. К. Григорьев,
В. М. Писарев
Publication year - 2021
Publication title -
obŝaâ reanimatologiâ
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.175
H-Index - 6
eISSN - 2411-7110
pISSN - 1813-9779
DOI - 10.15360/1813-9779-2021-5-35-51
Subject(s) - sepsis , medicine , gastroenterology , diabetes mellitus , septic shock , genotype , exact test , single nucleotide polymorphism , allele , biology , endocrinology , gene , genetics
Blood pressure dysregulation and circulatory failure are major contributors to the progression of sepsis and especially septic shock. One of the genes affecting the vascular endothelium and arteriolar tone is the angiotensin II receptor 1 gene ( AGTR 1). The AGTR 1 rs275651 single-nucleotide polymorphism is associated with the development of angina, high altitude pulmonary edema, and hypertension. The significance of the AGTR 1 rs275651 polymorphism in sepsis, particularly in patients with significant comorbidity, has not been studied previously. The aim of the study was to determine the impact of AGTR 1 functional polymorphism on sepsis outcome in patients with various comorbidities, including cardiovascular disease and type 2 diabetes mellitus. Material and methods . A prospective study included 144 ICU patients of two clinical hospitals in Moscow, aged 18-75 years with clinical signs of sepsis (Sepsis-3, 2016). Results . In the group of patients with cardiovascular diseases, carriers of the TT AGTR 1 rs275651 genotype had a lower mortality rate compared with carriers of the A allele (25 deaths out of 33 versus 16 out of 16, respectively, P =0.041, Fisher's exact test; P =0.0019, log-rank test). In the group of patients with diabetes mellitus ( n =62), we also found significant differences in sepsis outcome based on the AGTR 1 rs275651 genotype variant. The subgroup of TT AGTR 1 rs275651 genotype carriers demonstrated significantly lower mortality compared with TA, AA genotypes carriers (27 deaths out of 41 and 20 out of 21, respectively, P =0.012, Fisher's exact test; OR=10.37; 95% CI: 1.26 to 85.5; P A (rs275651) with sepsis outcome in ICU patients with high-value baseline comorbidity: carriers of the more common TT genotype had lower mortality compared to carriers of the minor A allele.