肾素-血管紧张素系统基因多态性与糖尿病及合并肾病的关系

Associations of the polymorphisms in the renin-angiotensin system with type 2 diabetes mellitus and diabetic nephropathy

目的探讨血管紧张素I转换酶(ACE)基因及血管紧张素原(AGT)基因与2型糖尿病(DM)及合并糖尿病肾病(DN)的相关性。方法分别用PCR、突变基因分离聚合酶链反应(MS-PCR)技术对195例2型DM患者和136例正常对照者的ACEI/D与AGTM235T多态性进行检测。结果(1)DM组ACE-DD基因型和D等位基因频率均比对照组显著增高(P<0.001)。(2)DN(+)组ACE基因型和等位基因频率与DN(-)组比较无显著性差异。(3)AGT基因型分布与等位基因频率在3组中均无显著性差异。(4)联合分析ACE-DD型及AGT-TT型对DN(+)、DN(-)的OR分别为4.17和3.16;均高于单基因DD型及TT型的OR值。结论(1)ACEDD基因型和D等位基因可能是广西地区人群2型DM的易感因素。(2)未发现ACEI/D或AGTM235T多态性单一因素与2型DM患者中DN的发生有关联。(3)ACE-DD基因型与AGTM235T-TT基因型在2型DM及DN发生中有协同作用。

ObjectiveTo investigate whether two polymorphisms in the renin-angiotensin system(RAS)-ACE I/D and AGT M235T are associated with type 2 DM and DN. MethodsA case-control study was performed in 195 type 2 DM patients and 136 controls. The ACE I/D and AGT M235T polymorphisms were examed by PCR and mutagenically separated PCR(MS-PCR) respectively. [WT10.HZResults(1)The frequencies of ACE-DD genotype and ACE D allele were significantly higher in DM group than that in control group (P<0.001,respectively).(2)The ACE I/D polymorphism did not show any difference between DN(+) and DN(-) groups.(3) No significant differences in AGT M235T polymorphism among three groups. (4) DN(+) OR associated with a combined genotype(ACE-DD + AGT M235T-TT) was 4.17,DN(-) OR associated with this combined genotype was 3.16.Both were increased than those associated with single ACE-DD or AGT M235T-TT genotype. Conclusion(1) ACE-DD genotype and D allele may be risk factors of type 2 DM in Guangxi population. (2) None of the two polymorphisms (ACE I/D,AGT M235T) contributes to genetic susceptibility to DN in type 2 DM patients. ((3) The) results suggested a synergistic effect between ACE-DD genotype and AGT M235T-TT genotype on DN in type 2 DM.