痰湿质高血压患者胰岛素抵抗与脂联素基因相关性

Association of Adiponectin Gene Polymorphisms with Insulin Resistance in Hypertensive Patients with Phlegm-wetness Type Based on Traditional Chinese Medicine

目的探讨按中医体质分类的痰湿体质高血压患者胰岛素抵抗是否存在异常以及与脂联素基因多态性的关系。方法分析436例(痰湿质组228例,非痰湿质组208例)高血压患者胰岛素敏感指数(ISI)和胰岛素抵抗指数(HOMA-IR)与6个脂联素基因单核苷酸(SNP)多态性的相关性。结果①痰湿质组和非痰湿质组高血压患者ISI分别为-1.89±0.29和-1.87±0.29(P=0.007),HOMA-IR分别为0.53±0.29和0.52±0.29(P=0.007);②男性脂联素基因rs266729的CC型、rs1501299的CA型和rs182052的GG型中痰湿质组比非痰湿质组高血压患者胰岛素敏感性降低,胰岛素抵抗性增高,女性脂联素基因rs1063537的CC型、rs1063539的GG型和rs224176的TT型痰湿质组高血压患者的结果则相反。结论①痰湿质组高血压患者比非痰湿质组高血压患者存在胰岛素的敏感性降低,胰岛素抵抗性增高的现象,男性之间的差别显著,女性差异不显著;②脂联素基因多个位点可能是痰湿质高血压患者胰岛素抵抗的遗传标志之一,且存在性别上的差异。

Objective This study was aimed to investigate the relationship between insulin resistance (IR) and adiponectin gene polymorphisms in hypertensive patients with phlegm-wetness type based on the theory of traditional Chinese medicine (TCM). Methods A total of 436 hypertensive patients were recruited including 228 subjects with phlegm-wetness type and 208 non-phlegm-wetness type. Insulin sensitivity index (ISI) and HOMA-IR were measured and six single nucleotide polymorphisms (SNPs) were genotyped in adiponectin gene. Results ① The ISI (HOMA-IR) was-1.89±0.29(0.53±0.29) in hypertensive patients with phlegm-wetness type and-1.87±0.29(0.52±0.29) in non-phlegm-wetness type hypertensive patients (P=0.007 for both). ② In males with rs266729 CC,rs1501299 CA and rs182052 GG genotypes,the ISI was lower,while the HOMA-IR was higher in phlegm-wetness type hypertensive patients than those in non-phlegm-wetness type. In females with rs1063537 CC,rs1063539 GG and rs224176 TT genotypes,this trend was not seen. Conclusions ① Decreased ISI and increased HOMA-IR was noted in phlegm-wetness type hypertensive patients as compared with those in non-phlegm-wetness type,and significance was only persisted in males. ② The SNPs of adiponectin gene may serve as genetic markers for IR in phlegm-wetness type hypertensive patients,and there exists an obviously gender difference in this association between SNPs and IR.