血管紧张素转换酶基因多态性与2型糖尿病患者脑梗塞的关系  

Association between angiotensin converting enzyme gene polymorphism and cerebral infarction in type 2 diabetic patients

作　　者：段文澜[1] 方京冲[1] 杨海春[1] 朱蔚珏 谢洁怡 杨秀芳[1] 俞茂华[1] 朱禧星[1] 

机构地区：[1]上海医科大学附属华山医院糖尿病研究室

出　　处：《中华内分泌代谢杂志》1999年第3期156-159,共4页Chinese Journal of Endocrinology and Metabolism

摘　　要：目的探讨血管紧张素转换酶（ＡＣＥ）基因多态性与２型糖尿病脑梗塞间的关系。方法应用多聚酶链反应（ＰＣＲ）技术，对１０９名２型糖尿病患者及５２名正常对照者的ＡＣＥ基因插入／缺失（Ｉ／Ｄ）型多态性进行检测，并用Ｌｏｇｉｓｔｉｃ多元逐步回归，筛选出２型糖尿病患者脑梗塞的高危因素。结果（１）糖尿病总组ＡＣＥ基因型频率和等位基因频率与正常对照组无显著性差异（Ｐ＞０．０５）。（２）糖尿病脑梗塞组ＡＣＥ基因ＤＤ型和Ｄ等位基因频率显著高于非脑梗塞组（Ｐ＜０．０１）及正常对照组（Ｐ＜０．０５）。（３）多元逐步回归分析显示：ＡＣＥ基因ＤＤ型、Ｄ等位基因、脂蛋白（ａ）及年龄是糖尿病脑梗塞的独立危险因素，而ＡＣＥ基因ＩＩ型和Ｉ等位基因则为２型糖尿病脑梗塞的保护因子。结论ＡＣＥ基因Ｉ／Ｄ多态性与２型糖尿病脑梗塞的发病密切相关。Objective To investigate the association between angiotensin converting enzyme (ACE) gene insertion/deletion (I/D) polymorphism and cerebralinfarctionintype2 diabetic patients. Methods ACE gene I/D polymorphism within intron 16 was determined by polymerase chain reaction (PCR) in 109 type 2 diabetic patients and 52 normal controls. Variables, including blood pressure, HbA 1c, FMN, serum lipid profile, apoproteins, lipoprotein(a), serum C peptide and ACE gene I/D polymorphism, were analyzed by multivariate stepwise logistic regression to determine the independent and significant risk factors for cerebral infarction in type 2 diabetic patients. Results (1)No significant difference in genotype and allele frequency of ACE gene was observed between type 2 diabetic patients and control group. (2)The DD genotype and D allele were more common in diabetic patients with cerebral infarction (0.43 and 0.60) than in those without cerebral infarction (0.13 and 0.37, P<0.01) and control group (0.17 and 0.39, P<0.05). (3) Multivariate stepwise regression analysis showed that DD genotype, D allele, lipoprotein(a), and age contributed significantly to cerebral infarction in type 2 diabetic patients. The odds ratios (95%CI) were 7.69(2.35～25.19), P=0.001; 5.47(1.39～21.56),P=0.015; 1.12(1.03～1.22),P=0.011 and 1.09(1.03～1.16),P=0.004, respectively. However, II genotype and I allele were shown to be protective factors for cerebral infarction in type 2 diabetic patients, the odds ratios (95%CI) were 0.28(0.13～0.60), P=0.001 and 0.21(0.05～0.79), P=0.022, respectively. Conclusion DD genotype and D allele of ACE gene were independent risk factors for cerebral infarction in type 2 diabetic patients. ACE gene I/D polymorphism analysis by PCR is conducive to early detection of diabetic patients susceptible t

关 键 词：脑梗塞 糖尿病 Ⅱ型 ACE 基因多态性 

分 类 号：R587.2[医药卫生—内分泌] R743.330.2[医药卫生—内科学]