PCOS患者MTHFR C677T基因多态性与胰岛素峰值后移的相关性研究  

Relationship between MTHFR C677T Polymorphism and Insulin Peak Shift in Patients with PCOS

作　　者：朱琳[1] 陈跃瑜[1] 林延润 杨发达[1] ZHU Lin;CHEN Yueyu;LIN Yanrun;YANG Fada(Department of Clinical Laboratory,Nanhai District Maternal and Child Health Hospital of Foshan City,Guangdong Foshan 528200,China)

机构地区：[1]佛山市南海区妇幼保健院检验科,广东佛山528200

出　　处：《现代检验医学杂志》2023年第6期54-58,141,共6页Journal of Modern Laboratory Medicine

基　　金：佛山市自筹经费类科技创新项目入库培育项目(编号:2220001004289):PCOS患者胰岛素峰值后移与MTHFRC677T基因多态性的相关性研究。

摘　　要：目的 探讨多囊卵巢综合征(polycystic ovary syndrome,PCOS)患者亚甲基四氢叶酸还原酶(methylene tetrahydrofolate reductase,MTHFR)C677T基因多态性与胰岛素峰值后移的关系,并分析不同基因型对胰岛素功能的影响。方法 选取2022年1月~2023年1月在佛山市南海区妇幼保健院就诊的PCOS患者191例,同时进行MTHFR基因C677T位点、胰岛素释放试验(insulin release test,IRT)和空腹血糖(fasting plasma glucose,FPG)检测。根据IRT峰值所在的时间点进行分组,峰值在120或者180min的患者纳入后移组(n=65),在30或者60min的纳入无后移组(n=126),比较两组基因型分布和等位基因频率的差异;分析组内不同基因型对FPG, IRT各时间点血清胰岛素水平、胰岛素抵抗指数(insulin resistance index,IRI)、胰岛素敏感指数(insulin sensitivity index,ISI)和胰岛素曲线下面积(area under the curve,AUC)的影响。结果 (1)后移组和无后移组MTHFR C677T三种基因型(CC,CT,TT)的分布为36.92%,40.00%,23.08%和61.11%,30.16%,8.73%;等位基因(C,T)的频率为56.92%, 43.08%和76.19%,23.81%,差异均有统计学意义(χ^(2)=12.47,15.06;P=0.020,0.000)。(2)单因素方差分析显示,无后移组三种基因型的空腹胰岛素(fasting insulin,Fins)和IRI差异有统计学意义(F=6.569,5.928,P=0.002,0.003);CT型、TT型均高于CC型[Fins:12.56(9.39,15.49),12.59(9.56,22.48) vs 8.75(5.43,13.50);IRI:2.75(1.96,3.53),3.16(2.01,4.83) vs1.87(1.28,3.03)],差异均有统计学意义(t=2.66~2.93, P=0.004~0.009)。(3)后移组三种基因型单因素方差分析显示,Fins和ISI差异有统计学意义(F=3.827,3.559,P=0.027,0.034),相比于CC型,CT型和TT型的Fins升高[13.00(9.29,20.74),13.92(7.84,18.03) vs 8.67(6.73,10.66)],而ISI降低[0.016(0.010,0.023),0.014(0.011,0.025) vs 0.022(0.018,0.033)],差异均有统计学意义(t=2.11~2.51, P=0.015~0.039)。结论 PCOS患者MTHFR C677T基因位点多态性与胰岛素峰值后移有关,基因突变患者Fins升高。在未发生峰值后移的患者中,基�Objective To investigate the relationship between C677T polymorphism of methylene tetrahydrofolate reductase(MTHFR)and peak shift of insulin in patients with polycystic ovary syndrome(PCOS),and the insulin function of different genotypes were compared.Methods A total of 191 women with PCOS were recruited from January 2022 to January 2023 at Nanhai District Maternal and Child Health Hospital in Foshan.The polymorphism of MTHFR gene C677T,insulin release test(IRT)and fasting plasma glucose(FPG)were measured.According to the peak time of IRT,the patients were divided into peak-shift group(n=65)at 120 or 180min and non-peak-shift group(n=126)at 30 or 60min,differences of genotype distribution and allele frequency between the two groups were analyzed.Comparing FPG,serum insulin level at each time point of IRT,insulin resistance index(IRI),Insulin sensitivity index(ISI)and area under the curve(AUC)between different genotypes in the two groups.Results①The frequencies of three MTHFR C677T genotypes(CC,CT,TT)in peak-shift group and non-peak-shift group were 36.92%,40.00%,23.08%and 61.11%,30.16%,8.73%,and the distribution frequency of C and T were 56.92%,43.08%and 76.19%,23.81%,and the differences were statistically significant(χ^(2)=12.47,15.06,P=0.020,0.000).②One-way ANOVA showed that there were significant differences in fasting insulin(Fins)and IRI among the three genotypes in the non-post shift group(F=6.569,5.928,P=0.002,0.003).Fins and IRI of CT and TT genotype were higher than those of CC genotype[Fins:12.56(9.39,15.49),12.59(9.56,22.48)vs 8.75(5.43,13.50);IRI:2.75(1.96,3.53),3.16(2.01,4.83)vs 1.87(1.28,3.03)],and the differences were statistically significant(t=2.66~2.93,P=0.004~0.009).③Fins and ISI were significantly different among the three genotypes(F=3.827,3.559,P=0.027,0.034).Compared with CC genotype,Fins of CT genotype and TT genotype increased[13.00(9.29,20.74),13.92(7.84,18.03)vs 8.67(6.73,10.66)],while ISI decreased[0.016(0.010,0.023),0.014(0.011,0.025)vs 0.022(0.018,0.033)],the differences we

关 键 词：多囊卵巢综合征 亚甲基四氢叶酸还原酶 胰岛素释放试验 胰岛素峰值后移 

分 类 号：R711.75[医药卫生—妇产科学] Q786[医药卫生—临床医学]