ACE基因多态性与老年人肾功能下降的相关性研究  

Angiotensin-converting enzyme gene insertion/deletion polymorphism and decline of renal function in elderly

作　　者：吴霖[1] 郑戈 陶婷[1] WU Lin;ZHENG Ge;TAO Ting(Department of Geriatrics,Ruijin Hospital,Shanghai Jiao Tong University,School of Medicine,Shanghai 200025,China;Nanmotou Community Health Service Center,Pudong District,Shanghai 200125,China)

机构地区：[1]上海交通大学医学院附属瑞金医院老年病科,上海200025 [2]上海市浦东新区南码头社区卫生服务中心,上海200125

出　　处：《诊断学理论与实践》2019年第2期204-208,共5页Journal of Diagnostics Concepts & Practice

基　　金：上海市卫生计生系统(2015ZB0503)

摘　　要：目的 :本研究拟通过回顾性分析血管紧张素转换酶(angiotensin converting enzyme,ACE)基因多态性与中国老年人肾功能下降间的相关性。方法:收集366例至老年科就诊或体检的老年患者(年龄≥60岁),记录其病史,并测量身高、体重,测定肝、肾功能、血脂及血糖等指标;采用PCR对其进行ACE基因分型。分别在2011年及2016年对其进行回顾性观察,去除失随访、死亡患者及数据不完整的样本后,剩余152例患者纳入本研究。根据ACE基因型将其分为DD+ID组及II组,比较2组间的内生肌酐清除率下降程度。结果:与2010年比较,2016年时152例老年患者的体重及内生肌酐清除率均明显下降(P<0.05),其空腹血糖水平则明显上升(P<0.05),而其血脂水平、糖尿病及高血压发病率在2次随访间差异无统计学意义(P>0.05)。根据ACE基因分型分组比较,2010年及2016年时,DD+ID组与II组间的年龄、体重、血糖、血脂水平及糖尿病发病率、高血压发病率上均无统计学差异(P>0.05),而ID+DD组2次随访期间的内生肌酐清除率下降程度大于II组[(-8.85±10.03) mL/min比(-5.20±10.32) mL/min],2组间差异有统计学意义(P<0.05)。结论:ACE基因D等位基因是中国老年人肾功能下降的独立危险因素。Objective: ACE is the key enzyme of renin-angiotension-aldosterone system(RAAS). The insertion(I allele) deletion(D allele) polymorphism of ACE gene determines the serum level of ACE. There are three genotypes including DD, ID and II. The aim of this study was to study the possible impact of this polymorphism on risk of renal function decline in Chinese elderly people. Methods: A total of 366 elderly patients from geriatrics department of Ruijin Hospital in 2010 was enrolled. Medical history(hypertension and diabetes) was collected, weight and the basic clinical characteristics were measured. Polymerase chain reaction(PCR) was used to determine the ACE genotypes(ID, II, DD).Patients were followed up in 2011 and 2016. After excluding the dead and those lost to follow-up, 152 cases were remained for analysis. These patients were divided into two groups according to the ACE genotypes, the group DD+ID and the group II. Results: Retrospective analysis showed that the 6 years follow-up demonstrated a trend of decline of weight and creatinine clearance rate(Ccr)(P <0.05) and a trend of rising of fast blood glucose level(P <0.05). There were no significant differences in fast blood lipid level, the incidence of diabetes and hypertension(P >0.05). There were no significant differences between group DD +ID and group II for weight, sex, age, fast blood glucose level, fast blood lipid level, incidence of diabetes and hypertension(P>0.05). Group DD+ID had more decline of Ccr than group II(P<0.05).Conclusions: The D allele of ACE gene is a risk factor of decline of kidney function in Chinese elderly people.

关 键 词：血管紧张素转换酶 基因多态性 肾功能 老年人 

分 类 号：R692.5[医药卫生—泌尿科学]