An investigation on the effects of peroxisome proliferator-activated receptor gamma functional gene variations in patients with restenosis after coronary angioplasty

Increased restenosis risk after percutaneous transluminal coronary angioplasty (PTCA) or stenting are affected by genetic factors as well as clinical and angiographic characteristics. In the present study, we investigated PPAR-gamma Pro12Ala(rs1801282) and C161T(rs3856806) variations effects on restenosis development and clinical parameters following PTCA. For this purpose, 132 patients with CAD (73 with restenosis, 59 without restenosiswere selected as the experimental group, and 124 healthy individuals were selected as the control group. Polymorphisms were determined using Polymerase Chain Reaction-Restriction Fragment Length Polymorphism (PCR-RFLP) and gel electrophoresis techniques. The PPARgamma Pro12Ala genotype distributions were the same between study groups (p>0.05). However, C161T rare T161 allele frequency was higher in CAD patients without restenosis compared to restenosis (p=0,001) and control (p=0,002) groups. When the effect of PPAR-gamma Pro12Ala polymorphism on clinical and biochemical parameters was examined, serum triglyceride level was higher in controls with Ala12allele than in ProPro genotype(p=0.01).In CAD patients without restenosis following PTCA, rare Ala12allele was associated with low fasting plasma glucose level compared to normal ProPro genotype (p=0.015),while rare T161 allele was associated with higher triglyceride level compared to normal C161T-CC genotype (p=0.023). The study revealed a high prevalence of type 2 diabetes (T2DM) (p=0.045) and hyperlipidemia (p=0.001) among patients with restenosis after PTKA. The C161T-T161 allele frequency was high in patients with T2DM compared with non-diabetic patients in patients with restenosis (p=0.019). In logistic regression analysis, T161 allele was found to be protective (p=0.001) and hyperlipidemia was a risk factor (p=0.002) for restenosis. In conclusion, our findings suggest that rare T161 allele of PPARgamma C161T polymorphism may be a risk factor for the development in coronary artery disease and type 2 diabetes. However, C161T polymorphism might have a protective effect on restenosis risk. PPAR-gamma Pro12Ala mutation had no effect on restenosis risk but it shows an atherogenic effect on serum lipid profile in controls.