降钙素受体基因多态性与上海地区绝经后妇女骨代谢和糖代谢及骨密度的关系  

Relationship between calcitonin receptor gene polymorphism and bone metabolism,glucose metabolism,bone mineral density of postmenopausal women in Shanghai

作　　者：杨军[1] 王博[2] 宣淼[1] 李颖[1] 褚燕倩 张秀珍[1] YANG Jun;WANG Bo;XUAN Miao;LI Ying;CHU Yanqian;ZHANG Xiu-zhen(Department of Endocrinology,Tongji Hospital of Tongji University,Shanghai 200065,China)

机构地区：[1]上海市同济医院内分泌科,200065 [2]上海市杨浦区中心医院内分泌科 [3]上海市申德医院内分泌科

出　　处：《中华临床医师杂志（电子版）》2012年第22期7255-7260,共6页Chinese Journal of Clinicians(Electronic Edition)

摘　　要：目的探讨上海地区绝经后2型糖尿病(T2DM)和骨质疏松(OP)症妇女患者的降钙素受体(CTR)基因多态性的分布及其与骨密度(BMD)、骨代谢、糖代谢的关系。方法选取上海地区无亲缘关系的绝经后汉族妇女406例,单纯OP组[96例,年龄(59.96±3.12)岁,BMI(20.51±1.72)kg/m2,绝经年限(7.42±1.64)年]、单纯T2DM组[118例,年龄(60.60±3.20)岁,BMI(24.18±1.77)kg/m2,绝经年限(7.37±1.54)年]、T2DM+OP组[90例,年龄(60.20±3.27)岁,BMI(20.97±1.53)kg/m2,绝经年限(7.34±1.46)年]、健康老年对照组[102例,年龄(60.50±2.8)岁,BMI(21.88±1.43)kg/m2,绝经年限(7.53±1.30)年]。应用聚合酶链反应-限制性酶切片段长度多态性分析技术检测CTR基因多态性,同时检测腰椎(L2～4)、股骨颈BMD、骨代谢指标、糖代谢指标。采用协方差分析校正年龄、绝经年限、BMI后比较各个临床指标与CTR基因型的相关性。结果在OP组中CC基因型组抗酒石酸酸性磷酸酶-5b(TRACP-5b)明显低于CT/TT基因型组(P值为0.013),血清骨碱性磷酸酶(BALP)则高于CT/TT基因型组(P值为0.019)。在OP组中CC基因型组L2～4BMD高于CT/TT基因型组(P值为0.026),经年龄、绝经年限、BMI校正后P值为0.025。T2DM组、T2DM+OP组、健康老年对照组基因型组L2～4BMD差异均无统计学意义(P值分别为0.799、0.258、0.183)。OP组、T2DM+OP组、健康老年对照组中CC基因型组股骨颈BMD高于CT/TT基因型组(P值分别为0.002、0.025、0.019),经年龄、绝经年限、BMI校正后P值为0.003、0.037、0.030。分别以T2DM及T2DM+OP有无作为因变量,以CTR基因型、年龄、BMI作为自变量,Logistic回归分析,CTR基因型(CC型和非CC型)并未增加T2DM骨量正常人群和T2DM+OP人群的患病风险性(OR=0.753,95%CI0.339～1.676,P=0.488;OR=0.796,95%CI0.381～1.665,P=0.545)。结论上海地区汉族绝经后妇女CTR基因分布以CC型为主,分布频率无显著差异。T2DM骨量正常患者BMD增高与BMI、胰岛素水平呈正相关。CTR基�Objective To explore the distribution of polymorphism in cacitonin receptor(CTR)gene and the association of CTR gene with glycometabolism,bone transformation and bone mineral density(BMD)variation in postmenopausal women with type 2 diabetes mellitus(T2DM)and osteoporosis(OP)in Shanghai region.Methods Four hundred and six unrelated post-menopausal women of Han nationality in Shanghai region were recruited and divided into four groups.OP group,T2DM group,T2DM and OP group,healthy control group.The CTR genotypes were determined by polymerase chain reaction(PCR)and restriction fragment length polymorphism(RFLP).The bone mineral density(BMD)were measured by dual-energy X-ray absorptiometry(DXA,Lunar,US)at two different sites(lumbar spine L2-4 and femoral neck).Glycometabolism index,the bone transformation biochemical indicator have been detected.In addition raw clinical index and genotype were adjusted by age,years since menopause and body mass index(BMI)as covariates.Results The CC genotype was significant lower higher than CC/TT genotype(P value showed 0.013)in TRACP-5b,while the CC genotype was significant higher than CC/TT genotype(P value showed 0.019)in BALP in the group OP.The CC genotype was significant higher than CC/TT genotype(P value showed 0.025)in the spine L2-4 BMD,while the P value showed 0.025 when the spine L2-4 BMD was adjusted by age,years since menopause and BMI in the group OP.There were no significant differences in the spine L2-4 BMD among the CTR genotypes in the group T2DM,T2DM and OP,healthy control(P value showed 0.799,0.258,0.183).The CC genotype was significant higher than CC/TT genotype(P value showed 0.002,0.025,0.019)in the femoral neck BMD,while the P value showed 0.003,0.037,0.030 when the femoral neck BMD was adjusted by age,years since menopause and BMI in the group OP,T2DM and OP,healthy control.When a binary logistic regression analysis was perfomed with the presence of T2DM as a dependent variable and CTR genotypes,age and BMI as in dependent variables,CTR genotypes were not fo

关 键 词：受体 降钙素 多态性 单核苷酸 糖尿病 2型 骨质疏松 绝经后 骨密度 

分 类 号：R580[医药卫生—内分泌]