降钙素受体基因多态性与昆明地区2型糖尿病伴骨质疏松症的相关性  

Association between Calcitonin Receptor Gene Polymorphism and Type 2 Diabetes with Osteoporosis in Kunming

作　　者：李博一[1] 牛玲[1] 马蓉 张娴[1] 刘方 唐艳[1] 苗翠娟 韩竺君[1] 张程 LI Bo-yi;NIU Ling;MA Rong;ZHANG Xian;LIU Fang;TANG Yan;MIAO Cui-juan;HAN Zhu-jun;ZHANG Cheng(Dept.of Endocrinology,The First People’s Hospital of Kunming,Kunming Yunnan 650011,China)

机构地区：[1]昆明市第一人民医院内分泌科,云南昆明650011

出　　处：《昆明医科大学学报》2021年第7期57-63,共7页Journal of Kunming Medical University

基　　金：云南省科技厅-昆明医科大学应用基础研究联合专项基金资助项目2018FE001(-098)

摘　　要：目的研究降钙素受体(CTR)基因多态性与昆明地区2型糖尿病(T2DM)伴骨质疏松症的相关性,探讨T2DM伴骨质疏松症发病的遗传性易感因素。方法收集2017年6月至2019年1月在昆明市第一人民医院甘美医院内分泌科住院的T2DM患者237例,按骨密度结果分为T2DM无骨质疏松组(A组)61例,T2DM合并骨量减少组(B组)111例,T2DM伴骨质疏松组(C组)65例,采用聚合酶链反应(PCR-RFLP),限制性片段长度多态性技术,对3组人群的CTR基因进行多态性分析;比较3组患者性别、年龄、糖尿病病程、血压、身高、体重、体重指数(BMI)、空腹血糖(FPG)、糖化血红蛋白(HbA1c)、血钙、血脂、血尿酸(UA)、维生素D浓度、雌激素、睾酮水平,超敏C-反应蛋白(Hs-CRP)、纤维蛋白原(FIB),口服葡萄糖耐量(OGTT)-0 h、2 h血糖,0 h、2 h胰岛素(INS)水平,胰岛素抵抗指数(HOMA-IR)临床指标;同时比较237例T2DM及65例T2DM伴骨质疏松患者CTR基因型中不同部位的骨密度;将CTR基因型及3组间具有统计学差异的临床等指标进行多因素Logistic回归分析。结果(1)昆明地区T2DM和T2DM伴骨质疏松症患者,CTR基因型以CC型为主;(2)A、B、C3组,CTR基因型分布频率差异无统计学意义(P>0.05),3组CTR等位基因C、T的分布频率差异无统计学意义(P>0.05);(3)3组患者年龄、身高、体重、BMI比较,差异有统计学意义(P<0.05),且两两比较,差异有统计学意义(P<0.017);(4)T2DM及T2DM伴骨质疏松症患者中,CTR不同基因型在各部位的骨密度差异无统计学意义(P>0.05);(5)多因素Logistic回归分析显示:年龄是昆明地区T2DM伴骨质疏松症的独立危险因素。结论(1)昆明地区T2DM和T2DM伴骨质疏松症患者CTR基因分布以CC型为主;(2)T2DM骨量正常组,T2DM骨量减少组,T2DM伴骨质疏松症患者中,CTR基因型分布频率,等位基因分布频率无显著差异;T2DM及T2DM伴骨质疏松患者中,CTR不同基因型在各部位的骨密度无差异,CTR基因型可能Objective To study the relationship between calcitonin receptor(CTR)gene polymorphism and type 2 diabetes(T2DM)with osteoporosis in Kunming area,and to explore the genetic predisposing factors of T2DM with osteoporosis.Methods A total of 237 T2DM patients who were hospitalized in the Department of Endocrinology,Ganmei Hospital,the First People’s Hospital of Kunming from June 2017 to January 2019 were collected.According to the results of bone mineral density,they were divided into T2DM without osteoporosis(group A),61 cases,and T2DM combined with osteopenia(Group B),111 cases,T2DM with osteoporosis group(Group C)65 cases.By using polymerase chain reaction(PCR-RFLP)and restriction fragment length polymorphism technology,we analyzed the CTR gene polymorphism of the three groups of people,and compared the three groups of patients with gender,age,diabetes course,blood pressure,height,weight,body mass index(BMI),fasting blood glucose(FPG),glycosylated hemoglobin(HbA1c),blood calcium,blood lipids,blood uric acid(UA),vitamins D concentration,estrogen,testosterone levels,high-sensitivity C-reactive protein(Hs-CRP),fibrinogen(FIB),oral glucose tolerance(OGTT)-0 h,2 h blood glucose,0 h,2 h insulin(INS)levels,insulin Resistance index(HOMA-IR)clinical indicators.We also compared the bone mineral density of different parts of the CTR genotype in 237 cases of T2DM and 65 cases of T2DM with osteoporosis,and compared the CTR genotype and the clinical indicators with statistical differences between the three groups Multivariate logistic regression analysis.Results(1)In patients with T2DM and T2DM with osteoporosis in Kunming area.The CTR genotype was mainly type CC.(2)There was no significant difference in the distribution frequency of CTR genotype between the three groups A,B and C(P>0.05).The distribution frequencies of CTR alleles C and T in the three groups were not statistically different(P>0.05).(3)There was a statistically significant difference in the age,height,weight,and BMI of the three groups of patients(P<0.05).And

关 键 词：降钙素受体基因多态性 2型糖尿病 骨质疏松症 

分 类 号：R587.1[医药卫生—内分泌]