单核苷酸基因多态性与妊娠期糖尿病合并HBV感染CDKN2A的关联  

Association of CDKN2A single nucleotide gene polymorphism in patients with gestational diabetes mellitus combined with HBV infection

作　　者：陈晨 丁丽娟 王妮 钱丽 黄劲松 CHEN Chen;DING Li-juan;WANG Ni;QIAN Li;HUANG Jin-song(The Affiliated Wuri People's Hospital of Nanjing Medical University(Wuxi People's Hospital,Wuri Medical Center,Nanjing Medical University),Wui,Jiangsu 214023,China)

机构地区：[1]南京医科大学无锡医学中心(无锡市人民医院、南京医科大学附属无锡人民医院)妇产科,江苏无锡214023

出　　处：《中华医院感染学杂志》2024年第12期1855-1859,共5页Chinese Journal of Nosocomiology

基　　金：无锡市卫生健康委妇幼健康科研基金资助项目(FYKY202202)。

摘　　要：目的探讨妊娠期糖尿病合并乙型肝炎病毒(HBV)感染患者细胞周期依赖性激酶抑制基因(CDKN2A)单核苷酸基因多态性及其肝功能.方法选取2019年5月-2022年1月无锡市人民医院收治的106例妊娠期糖尿病合并HBV感染患者作为研究组,另选取115例未合并HBV感染的妊娠期糖尿病患者为对照组;比较两组CDKN2A基因分布、等位基因频率、肝功能、免疫功能、胰岛β细胞功能、孕妇妊娠结局及新生儿并发症.结果研究组CDKN2A TT基因型及T等位基因的频率均高于对照组(P<0.05);研究组外周血CD_(3)^(+)、CD_(4)^(+)、CD_(4)^(+)/CD_(8)^(+)及β细胞功能指数(HOMA-β)均低于对照组;研究组血清丙氨酸氨基转移酶(ALT)、门冬氨酸氨基转移酶(AST)、总胆红素(TBil)、总胆汁酸(TBA)、外周血免疫球蛋白M(IgM)、IgA及胰岛素抵抗指数(HOMA-IR)均高于对照组(P<0.05);研究组不良妊娠结局发生率高于对照组(P<0.001);新生儿并发症发生率高于对照组(P<0.001).结论妊娠期糖尿病患者CDKN2A TT基因型及T等位基因与HBV感染具有密切关系,且HBV感染会加重患者肝功能损伤,使患者免疫功能紊乱及胰岛素抵抗加重,并增加患者不良妊娠结局及新生儿并发症的风险.OBJECTIVE To investigate the single nucleotide polymorphism of cell cycle dependent kinase inhibitor gene(CDKN2A)in patients with gestational diabetes mellitus combined with hepatitis B virus(HBV)infection and their liver function.METHODS Totally 106 patients with gestational diabetes mellitus complicated with HBV infection admitted to Wuxi People's Hospital from May 2019 to Jan.2022 were selected as the study group,and 115 patients with gestational diabetes mellitus without HBV infection were selected as the control group.The CDKN2A gene distribution,allele frequency,liver function,immune function,pancreatic isletβCellfunction,pregnancy outcomes of pregnant women,and incidence of neonatal complications between the two groups were compared.RESULTS The frequencies of CDKN2A TT genotype and T allele in the study group were higher than those in the control group(P<0.05).The levels of peripheral blood CD_(3)^(+),CD_(4)^(+),CD_(4)^(+)/CD_(8)^(+)andβcell function index(HOMA-β)in the study group were lower than those in the control group.The levels of serum alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(TBil),total bile acid(TBA),peripheral blood immunoglobulin M(IgM),IgA,and insulin resistance index(HOMA-IR)in the study group were higher than those in the control group(P<0.05).The incidence of adverse pregnancy outcomes in the study group was higher than that in the control group.The incidence of neonatal complications was higher than that in the control group(P<0.05).CONCLUSION The CDKN2A TT genotype and T allele in patients with gestational diabetes were closely related to HBV infection,and HBV infection exacerbated hepatic impairment,worsened the immune dysfunction and insulin resistance,and increased the risk of adverse pregnancy outcomes and neonatal complications.

关 键 词：妊娠期糖尿病 乙型肝炎病毒 细胞周期依赖性激酶抑制基因 肝功能 免疫功能 妊娠结局 关联 

分 类 号：R512.62[医药卫生—内科学]