【作者】 左春林；

【导师】 杨明功； 刘树琴； 王长江；

【作者基本信息】 安徽医科大学 ， 内科学， 2003， 硕士

【摘要】 目的 研究甲硫氨酸合成酶(MS)基因A2756G多态性与2型糖尿病大血管并发症(本文主要指2型糖尿病合并冠心病和2型糖尿病合并脑梗死)的关系。方法 采用聚合酶链反应—限制性片段长度多态性(PCR-RFLP)方法鉴定安徽地区733例汉族人MS基因A2756G多态性基因型，比较基因型频率及等位基因频率并进行群体关联分析；并且对各组间临床一般资料，糖、脂代谢相关指标进行比较。733例受试者分为四组：对照组(CON)178例，无大血管及微血管并发症的2型糖尿病组(T2DM)273例，2型糖尿病大血管并发症组(T2DM+AS)189例(其中包括合并冠心病64例，合并脑梗死111例，合并糖尿病足14例)以及不伴糖尿病的单纯大血管病变组(AS)93例(其中包括冠心病16例，脑梗死77例)。结果 安徽地区汉族人群存在MS基因A2756G多态性，其G等位基因频率与西方人群比较明显降低，具有统计学显著性差异(P＜0.05)；2型糖尿病大血管并发症组及其亚组的不同基因型及等位基因频率与对照组比较，无统计学显著性差异(P＞0.05)。临床一般资料中，2型糖尿病大血管并发症组及其亚组的年龄、收缩压与2型糖尿病组比较，具有统计学显著性差异(P＜0.05)。Logistic回归分析表明，MS基因A2756G多态性不参与2型糖尿病大血管并发症的致病过程(G等位基因OR=0.855，95％CI=0.529～1.383，P=0.523)，而年龄、收缩压与2型糖尿病大血管并发症独立显著相关(年龄OR=1.076，95％CI=1.028～1.127，P=0.002；收缩压OR=1.028，95％CI=1.002～1.054，P=0.033)。结论 年龄、收缩压可能是2型糖尿病大血管并发症的独立危险因素，MS基因A2756G多态性与安徽地区汉族人群2型糖尿病大血管并发症的遗传易感性无关。更多还原

【Abstract】 Objective To explore the association between A2756G polymorphism of methionine synthase (MS) gene and type 2 diabetes mellitus with macrovascular complications. Methods The genotypes of MS gene A2756G polymorphism were determined by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique in 733 Chinese Han population of Anhui region including 178 normal subjects (CON), 273 diabetics without angiopathy (T2DM), 189 patients with diabetic macrovascular complications of atherosclerosis (T2DM+AS) [64 with coronary heart disease (T2DM+CHD), 111 with cerebral infarction (T2DM+CI) and 14 with diabetic food] and 93 non-diabetic patients with macroangiopathy of atherosclerosis (AS) [16 with coronary heart disease (CHD) and 77 with cerebral infarction (CI)]. We compared the genotype and allele frequencies in these groups and studied the relationship between the polymorphism and diabetic macrovascular complications by population-based association analysis. Results The G allele prevalences of MS gene A2756G polymorphism in Chinese Han population of Anhui region were significantly lower than that in western populations (P<0.05). There were no significant differences in the genotype and allele frequencies among these groups of CON,T2DM,T2DM+AS and AS (P>0.05). By general clinical characteristics age as well as systonic blood pressure (SBP) was significantly increased in T2DM+AS group or subgroups compared with T2DM (P<0.05). Logistic regression analysis showed that not the polymorphism but age increment or SBP was related independently and significantly to type 2 diabetes mellitus with macrovascular complications (OR=0.855, 95%CI=0.529~1.383, P=0.523 for G allele; OR=1.076,95%CI=1.028~1.127,P=0.002 for age; OR=1.028, 95%CI=1.002-1.054,P=0.033 for SBP). Conclusions The results suggested that age increment as well as SBP is an independent risk factor for type 2 diabetes mellitus withmacrovascular complications and the MS gene A2756G polymorphism has no relationship to the hereditary susceptibility for that.更多还原