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目的研究糖尿病患者与正常人之间以及不同骨量糖尿病患者之间维生素D受体基因型的分布差异及临床意义。方法选取56例糖尿病患者作为观察组,另选同期体检的56例健康者作为对照组。采用聚合酶连反应限制性片段长度多态性技术对两组进行维生素D受体基因型检测,并分析比较不同骨量糖尿病患者不同部位骨密度分布情况,及VDR基因型与骨量变化的关系。结果维生素D受体基因结果可分为Aa、AA、aa等3个型号。观察组VDR基因型:Aa型19例(33.93%),AA型5例(8.93%),aa型32例(57.14%);对照组VDR基因型:Aa型20例(35.71%),AA型6例(10.71%),aa型30例(53.57%)。两组VDR基因型分布比较,差异无统计学意义(P>0.05)。56例糖尿病患者中,骨量正常患者23例(41.07%),骨量减少患者15例(26.79%),骨质疏松患者18例(32.14%)。不同骨量糖尿病患者各部位骨密度均呈下降趋势,差异具有统计学意义(P<0.05)。糖尿病患者VDR基因中,Aa、AA、aa基因各部位骨密度呈下降趋势,不同基因型骨密度比较,差异具有统计学意义(P<0.05)。骨质疏松、骨量减少患者aa基因型频率明显高于骨量正常患者,而Aa基因型频率又低于骨量正常患者,差异具有统计学意义(P<0.05)。结论糖尿病患者维生素D受体基因分布对比健康人群无明显差异;而糖尿病患者对应Apal酶切位点维生素D受体基因多态与患者骨质疏松存在必然关系。
Objective To study the distribution and clinical significance of vitamin D receptor genotypes between patients with diabetes mellitus and normal controls and between patients with different bone mass levels. Methods Fifty-six patients with diabetes mellitus were selected as the observation group, and 56 healthy subjects were selected as the control group. Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) was used to detect the genotypes of vitamin D receptor in two groups and to analyze the distribution of bone mineral density (BMD) in different parts of patients with different bone mass and the relationship between VDR genotype and bone mass . Results Vitamin D receptor gene results can be divided into Aa, AA, aa and other three models. The VDR genotype in observation group was 19 cases (33.93%) in type Aa, 5 cases (8.93%) in type AA and 32 cases (57.14%) in type aa. The VDR genotype in control group was 20 cases 6 cases (10.71%), aa type 30 cases (53.57%). There was no significant difference in the distribution of VDR genotype between the two groups (P> 0.05). Of the 56 diabetic patients, 23 (41.07%) had normal bone mass, 15 (26.79%) had osteopenia, and 18 (32.14%) had osteoporosis. The bone mineral density of different parts of patients with different bone mineral density showed a downward trend, the difference was statistically significant (P <0.05). The BMD of Aa, AA and aa decreased in VDR gene of diabetic patients. The BMD of different genotypes had statistical significance (P <0.05). The frequency of aa genotype in patients with osteoporosis and osteopenia was significantly higher than that in patients with normal bone mass, while the frequency of Aa genotype was lower than that in patients with normal bone mass. The difference was statistically significant (P <0.05). Conclusion There is no significant difference in the distribution of vitamin D receptor gene between diabetic patients and healthy people. However, there is a certain relationship between polymorphism of vitamin D receptor gene and osteoporosis in patients with diabetes.