摘要
目的:探讨脂蛋白脂酶基因HindⅢ多态性与2型糖尿病(DM)合并冠心病及胰岛素抵抗的关系。方法:随机选择2型DM患者203例,其中合并冠心病(CHD)76例(A组),无CHD的2型DM患者127例(B组),健康对照93例(C组),相互间无血缘关系;采用PCR-RFLP方法检测所有受试者脂蛋白脂酶(LPL)基因HindⅢ限制性酶切位点多态性,测量其血脂、血糖水平、DM组空腹胰岛素水平并进行体格检查,用HOMA模型公式计算胰岛素抵抗指数(HOMA-IR)和胰岛细胞敏感指数(HOMA-IS)。结果:DM组及对照组3种基因型均检出,为纯合子H+H+型、H-H-型,杂合子H+H-型;两组间基因型和等位基因分布频率差异无统计学意义(P>0.05);A组H+H+型56例,非H+H+型(包括H+H-型、H-H-型)20例,与B组患者差异有统计学意义(P<0.01);A组患者LPL基因H+H+型HOMA-IR明显高于非H+H+型者(P<0.01),且高于B组H+H+型和非H+H+型者(P<0.01)。同时,A组血TG升高、HDL降低,与B组、健康对照相比,差异具有统计学意义(P<0.01)。结论:高TG、低HDL是DM合并CHD的危险因素,LPL基因H+H+型携带者是DM发生CHD的易感亚群,LPL基因H+H+型与DM合并CHD患者胰岛素抵抗相关。
Objective: To explore the relationship between lipoprotein lipase(LPL) gene HindⅢ polymorphism and type 2 mellitus (DM) diabetes complicated coronary heart disease(CHD) accompanied with insulin resistance. Methods: Two hundred and three type 2 DM patients, included 76 with CHD(group A) and 127 without CHD (group B), and 93 healthy control were selected randomly. All had no blood relationship. The LPL gene Hind Ⅲpolymorphism was studied by polymerase chain reaction (PCR) and restriction fragment length polymorphisms (RFLP). The levels of serum lipid, blood glucose, indexes of height, weight, circumference of waist and abdomen, body mass index (BMI) and waist -to-hip ratio (WHR) were measured in all subjects. At the same time, the fasting insulin (FINS) was tested and the indexes of insulin resistense (IR) and insulin sensitivity(IS) were calculated by HOMA formula. Results: Three genotypes including homozygote H+H+ (+/+) were detected in this experiment homozygote H-H- (-/-) and homozygote H+H- (+/-).Homozygote H+H+ was the major allele in both diabetic group and control group. There was no significant difference in frequencies of genotypes or alleles between diabetic patients and controls; H+H+ genotype were detected 56 cases in group A which was significant higher than that in group B. HOMA-IR of H+H+ genotype in group A was higher than that of the other genotypes, and it was higher than that of H+H+ genotype and the other genotypes in group B. The level of serum triglyceride(TG)in group A was higher than that in group B. At the same time the level of serum highdensity lipoprotein (HDL) in group A was lower than that in group B. Conclusions: The high level of serum TG and the low level of HDL are the risk factors of DM with CHD. Type 2 DM patients carrying H+H+ genotype are the susceptible subcrowd of CHD. LPL gene H+H+ genotype is associated with IR in DM with CHD.
出处
《山东大学学报（医学版）》
CAS
北大核心
2005年第4期301-305,共5页
Journal of Shandong University:Health Sciences
