RAAS系统基因多态性与糖尿病肾脏病的关系  

The relationship between RAAS gene polymorphism and diabetic kidney disease

作　　者：刘志超 尹伟婵 廖湘平[1] 蒋显勇[2] LIU Zhi-chao;YIN Wei-chan;LIAO Xiang-ping;JIANG Xian-yong(Department of Nephrology,the First People's Hospital of Chenzhou,Chenzhou,Hunan 423000;Department of Laboratory Medicine,Affiliated Hospital of Xiangnan University,Chenzhou,Hunan 423000,China)

机构地区：[1]郴州市第一人民医院肾内科,湖南郴州423000 [2]湘南学院附属医院检验科,湖南郴州423000

出　　处：《热带医学杂志》2021年第6期695-699,共5页Journal of Tropical Medicine

基　　金：郴州市科技计划项目(CZ2015053);郴州市第一人民医院院级科研项目(N2013-010)。

摘　　要：目的研究肾素-血管紧张素-醛固酮系统(RAAS)4个关键基因[血管紧张素转化酶(ACE)基因I/D、血管紧张素原(AGT)基因M235T、醛固酮合成酶(CYP11B2)基因-344C/T、血管紧张素Ⅱ1型受体(AT1R)基因A1166C]多态性与2型糖尿病肾脏病(DKD)的关系。方法选取2017年1月至2019年7月郴州市第一人民医院2型糖尿病肾脏病患者132例(DKD+组),另外选择140例未合并肾脏病的2型糖尿病患者为DKD-组。采用飞行时间质谱的方法对以上4个基因进行分型,并测定血糖、血脂、内生肌酐清除率。结果 ACE基因I/D中,DKD+组DD基因型和D等位基因频率高于DKD-组,差异有统计学意义(χ^(2)=7.789,P=0.020;χ^(2)=8.116,P=0.004);AGT基因M235T中,DKD+组TT基因型和T等位基因频率高于DKD-组,差异有统计学意义(χ^(2)=6.904,P=0.032;χ^(2)=6.377,P=0.012);CYP11B2基因-344C/T中,DKD+组TT基因型和T等位基因频率高于DKD-组,差异有统计学意义(χ^(2)=8.968,P=0.011;χ^(2)=8.368,P=0.004);AT1R基因A1166C中,DKD+组AC基因型和C等位基因频率高于DKD-组,差异有统计学意义(χ^(2)=6.071,P=0.014;χ^(2)=5.779,P=0.016)。ACE基因I/D-DD基因型、ACE基因I/D-ID基因型和D等位基因,AGT基因M235T T等位基因,CYP11B2基因-344C/T-TT基因型、CYP11B2基因-344C/T-CT基因型和T等位基因以及AT1R基因A1166C-AC基因型和C等位基因均是糖尿病肾脏病发生的危险因素(P<0.05)。结论 ACE基因I/D-DD基因型、ACE基因I/D-ID基因型和D等位基因、AGT基因M235T T等位基因、CYP11B2基因-344C/T-TT基因型、CYP11B2基因-344C/T-CT基因型和T等位基因、AT1R基因A1166C-AC基因型和C等位基因是2型糖尿病肾脏病发生的危险因素。Objective To invetigate the association between four key genes of the renin-angiotensin-aldosterone system(RAAS):including the angiotensin converting enzyme(ACE)gene I/D polymorphism,the angiotensinogen(AGT)gene M235 T polymorphism,and aldosterone synthesis enzyme(CYP11 B2)gene-344 C/T polymorphism,the angiotensinⅡtype 1 receptor(AT1 R)gene A1166 C polymorphism and type 2 diabetic kidney disease(DKD). Methods 132 type 2 diabetic nephropathy patients(DKD+ group)in the First People’s Hospital of Chenzhou were included,and 140 type 2 diabetic patients without renal disease were selected as the control group(DKD-group). Time-of-flight mass spectrometry was used to perform the above genotyping,and the clearance rates of blood glucose,blood lipids and endogenous creatinine were measured and compared. Results In ACE gene I/D determination,the frequency of DD genotype and D allele in DKD+group was higher than that in DKD-group,the difference was statistically significant(χ^(2)=7.789,P=0.020;χ^(2)=8.116,P=0.004);in the determination of AGT gene M235 T,the frequency of TT genotype and T allele in DKD+ group was higher than that in the DKD-group,the difference was statistically significant(χ^(2)=6.904,P=0.032;χ^(2)=6.377,P=0.012);in the CYP11 B2 gene-344 C/T determination,the TT genotype and T allele frequencies in the DKD+ group were higher than in the DKD-group,the difference was statistically significant(χ^(2)=8.968,P=0.011;χ^(2)=8.368,P=0.004);in the AT1 R gene A1166 C determination of DKD+ group,the frequency of AC genotype and C allele in group was higher than that in DKDgroup,the difference was statistically significant(χ^(2)=6.071,P=0.014;χ^(2)=5.779,P=0.016). ACE gene I/D-DD genotype,ACE gene I/D-ID genotype and D allele, AGT gene M235 T T allele, CYP11 B2 gene-344 C/T-TT genotype,CYP11 B2 gene-344 C/T-CT genotype and T allele, AT1 R gene A1166 C-AC genotype and C alleles were risk factors for type 2 diabetic kidney disease. Conclusion ACE gene I/D-DD genotype,ACE gene I/D-ID genotype and D allele,AGT g

关 键 词：糖尿病肾脏病 基因多态性 血管紧张素转化酶 血管紧张素原 醛固酮合成酶 血管紧张素Ⅱ1型受体 

分 类 号：R587.1[医药卫生—内分泌] R692[医药卫生—内科学]