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目的 :探讨福建地区汉族2型糖尿病患者血清色素上皮衍生因子水平(pigment epithelium-derived factor,PEDF)及PEDF基因启动子区rs1294385单核苷酸多态性与微量白蛋白尿的关系。方法 :471例2型糖尿病患者根据尿白蛋白/肌酐比值(urinary albumin to creatinine ratio,UACR)分为正常组(UACR<30μg/mg,NAU组)246例、微量白蛋白尿组(30μg/mg≤UACR<300μg/mg,MAU组)225例,使用PCR-RFLP方法检测PEDF基因启动子区rs1294385的多态性,同时检测血清PEDF水平及空腹血糖、空腹胰岛素、糖化血红蛋白、血脂等指标。结果:MAU组的血清PEDF水平高于NAU组,差异有统计学意义(P<0.05);偏相关分析显示血清PEDF水平与UACR呈正相关(P<0.05);PEDF基因启动子区rs1294385的基因型(GG型、GA型和AA型)和等位基因(G/A)在NAU、MAU两组间的分布存在差异,且差异有统计学意义(P<0.05);GA基因型出现微量白蛋白尿的风险是GG基因型的1.838倍,GA+AA基因型出现微量白蛋白尿的风险是GG基因型的1.862倍,差异有统计学意义(P<0.05)。结论:2型糖尿病患者血清PEDF水平随微量白蛋白尿的出现而增高;福建地区汉族2型糖尿病患者PEDF基因启动子区rs1294385多态性与微量白蛋白尿明显相关,携带A等位基因可能增加2型糖尿病患者发生微量白蛋白尿的机率。
OBJECTIVE: To investigate the relationship between serum level of pigment epithelium-derived factor (PEDF) and rs1294385 SNP in patients with type 2 diabetes mellitus in Fujian Province and microalbuminuria. Methods: 471 patients with type 2 diabetes were divided into normal group (UACR <30μg / mg, NAU group), urinary albumin to creatinine ratio (246 cases) and microalbuminuria group (30μg / mg (UUA <300μg / mg, MAU group). PCR-RFLP method was used to detect the polymorphism of rs1294385 in PEDF gene promoter region. Meanwhile, serum PEDF levels, fasting blood glucose, fasting insulin, glycosylated hemoglobin and lipids were measured. Results: The level of serum PEDF in MAU group was significantly higher than that in NAU group (P <0.05). Partial correlation analysis showed that serum PEDF level was positively correlated with UACR (P <0.05). The genotype of rs1294385 in PEDF gene promoter region (GG, GA and AA) and allele (G / A) in NAU and MAU were significantly different between the two groups (P <0.05). There was significant difference between GA genotype microalbumin The risk of urinary excretion was 1.838 times that of GG genotype. The risk of developing microalbuminuria in GA + AA genotype was 1.862 times that of GG genotype (P <0.05). Conclusions: Serum PEDF levels in patients with type 2 diabetes increased with the appearance of microalbuminuria. The polymorphism of rs1294385 in promoter region of PEDF gene in type 2 diabetic Han patients was significantly associated with microalbuminuria in Han patients with type 2 diabetes mellitus, with the possibility of carrying the A allele The incidence of microalbuminuria in patients with type 2 diabetes.