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

作　　者：王劲松[1] 周玲[2] 成金罗[3] 沈默宇[3] 周金意[2] 

机构地区：[1]扬州大学医学院预防医学教研室,扬州225001 [2]南京医科大学流行病与卫生统计学系 [3]常州市第二人民医院内分泌科

出　　处：《中国公共卫生》2005年第11期1318-1319,共2页Chinese Journal of Public Health

基　　金：国家自然科学基金(30371241);江苏省社会发展基金(BS2000031)资助

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。Objective To explore the interaction between gene polymorphisms of angiotensin Ⅰ converting enzyme （ACE） and blood lipid in diabetic nephropathy （DN）. Methods Angiotensin I converting enzyme （ACE） genotypes were investigated with PCR techniques in 37 cases of DN and 72 controls of T2DM. Additive model was used to analyze the interaction. Results The frequency of DD genotype of the ACE gene in diabetic nephropathy patients was sygnificantly higher than that in the control subjects （75.7 % vs 55.6 %, P = 0.040）. The trend of increase was found between diabetic nephropathy and that non diabetic nephropathy in D allele frequency （87.8 % vs 77.1%, P = 0.057） but it was not statistically changed. Total triglyceride was higher in DN than that in the controls （P = 0.049）. There was a positive interaction between DD genotype and blood lipid （high TC and high TG）. Interaction index was 2.71, 4.29 and attributable interaction percent was 42.03 %, 62.60 %. Odds Ratio values were 4.52, 10.75 with DD genotype and high TC or high TG each other. Conclusion ACE gene I/D polymorphism may contribute to the genetic susceptibility of diabetic nephropathy in Chinese population and the interaction between DD genotype and blood lipid has a positive effect.

关 键 词：2型糖尿病 糖尿病肾病 血管紧张素Ⅰ转换酶 基因多态性 交互作用 

分 类 号：R181.3[医药卫生—流行病学] Q587.1[医药卫生—公共卫生与预防医学]