血脂与ACE基因多态性对糖尿病肾病交互作用
Study on interaction of ACE gene polymorphism and blood lipid in type 2 diabetes with nephropathy
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摘要:目的 探讨血管紧张素Ⅰ转换酶(ACE)基因的插入/缺失多态性与高血脂因素对糖尿病肾病发生的交互作用及其强度.方法 采用聚合酶链反应技术检测109例2型糖尿病(T2MD)患者(其中合并肾病患者37例, 未发生肾病患者72例)ACE基因插入/缺失多态性, 用相加模型分析其与高血脂对糖尿病合并肾病的交互作用.结果 糖尿病肾病患者的DD基因型频率高于无肾病糖尿病患者组(75.7%和55.6%, P=0.040), D等位基因频率也有升高的趋势, 差异接近显著性水准(87.8%和77.1%, P=0.057).肾病组甘油三酯水平高于单纯糖尿病组, 差异有统计学意义(P=0.049).ACE基因DD基因型与血脂对糖尿病肾病发生有明显正交互作用, 与总胆固醇、甘油三酯的交互作用系数分别为2.17, 4.29, 归因交互百分比分别为42.03%, 62.60%, OR(AB)值分别为4.52和10.75.结论 ACE基因的DD基因型可能增高2型糖尿病患者并发肾病的易感性, 并且与高总胆固醇、高甘油三酯有交互作用.Abstract:Objective To explore the inter action between gene polymorphisms of angiotensin Iconver ting enzyme(ACE)and blood lipid in diabetic nephropathy(DN).Methods Angiotensin Iconverting enzyme(ACE)g enotypes were investigated with PCR techniques in 37 cases of DN and 72 controls of T2DM.A dditive model was used to analyze the interaction.Results The frequency of DD genotype of the ACE gene in diabetic nephropathy patients was sygnificantly hig her than thatin the control subjects(75.7% vs 55.6%, P=0.040).The trend of increase was found between diabetic nephr opathy and thatnon diabetic nephropathy in Dallele frequency(87.8% vs 77.1%, P=0.057)butitwas notstatistically changed.Total triglyceride was higherin DN than thatin the controls(P=0.049).There was a positive interaction between DD genotype and blood lipid(high TC and high TG).I nteraction indexwas 2.71, 4.29 and attributable interaction per centwas 42.03%, 62.60%.Odds Ratio v alues were 4.52, 10.75 with DD genoty pe and high TC or high TG each other.Conclusion ACE gene I/D polymo rphism may contribute to the genetic susceptibility of diabetic nephr opathy in Chinese population and the inter action between DD genotype and blood lipid has a positive effect.
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