血管紧张素转换酶2基因多态性与2型糖尿病合并冠心病遗传易感性的关系

Relationship of angiotensin-converting enzyme 2 gene polymorphisms and vulnerability to coronary heart disease in patients with type 2 diabetes mellitus

目的探讨血管紧张素转换酶2(ACE2)基因多态性与2型糖尿病患者及其心血管并发症的关系。方法选择门诊与住院的汉族无血缘关系的糖尿病患者215例,分为单纯2型糖尿病组(121例)及T2DM合并冠心病组(94例)。应用PCR-RFLP方法检测ACE2基因多态性,并结合临床、生化指标及超声心动图参数进行分析。结果在2型糖尿病合并冠心病组患者中,男性G8790A位点G等位基因室间隔厚度明显高于A等位基因(P<0.01),左心室质量指数及校正后尿蛋白量均高于A等位基因(P<0.05)。而在糖尿病组及女性糖尿病合并冠心病组中未得出同样结论。结论ACE2基因G8790A位点多态性与男性2型糖尿病患者合并冠心病的室间隔、左室质量及尿蛋白含量有关。

Objective To investigate the association of angiotensin-converting enzyme 2 （ACE2） gene polymorphisms and coronary artery disease （CAD） in patients with type 2 diabetes mellitus （T2DM）. Methods This study involved 121 patients with T2DM and 94 with diabetic macroangiopathy. The polymophisms of G8790A in ACE2 gene was analyzed using PCR-restriction fragment length polymorphism analysis in these patients, and the clinical, biochemical and echocardiographic data were also analyzed. Results No obvious difference was found in the genotyping data between the two groups. Among the male patients with diabetic macroangiopathy, the interventricular septal end-diastolic thickness （IVSTd） were significantly greater in patients of GG genotypes of ACE2 gene G8790A than in those of AA genotypes （P〈0.01）, and the left ventricular mass （LVMI） and urine protein were also significantly higher in GG genotypes （P〈0.05）. No similar results were found the uncomplicated diabetic group or the female diabetic patients with CAD. Conclusion The ACE2 gene G8790A polymorphism plays a role in the pathogenesis of CAD in patients with type 2 diabetes, suggesting that ACE2 genotyping is helpful to screen the susceptible patients.