同型半胱氨酸及胱硫醚β-合成酶基因多态性与2型糖尿病合并冠心病的关系

Homocysteine and prevalence of polymorphism of CBS 844ins68 in type 2 diabetes mellitus patients with coronary heart disease

目的探讨我国北方汉族糖尿病(DM)合并冠心病(CHD)者同型半胱氨酸水平(Hcy)及Hcy代谢相关酶胱硫醚β-合成酶(CBS)的844ins68的基因多态性特点。方法检测104例2型DM合并CHD患者(DM合并CHD)、127例2型DM患者、61例CHD患者和91名健康对照者的Hcy、叶酸、维生素B12、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白A-I(apo A-I)、载脂蛋白B(apo B)浓度。应用聚合酶链反应(PCR)分析CBS 844ins68基因多态性。结果DM合并CHD组Hcy水平明显高于DM组和对照组,叶酸、维生素B12水平明显低于DM组及对照组(P<0.01)。DM合并CHD组与CHD组Hcy、叶酸、维生素B12水平差异无统计学意义(P>0.05)。DM组与对照组之间Hcy、叶酸、维生素B12水平差异无统计学意义(P>0.05)。4组CBS 844ins68的基因型及等位基因频率差异均无统计学意义(P>0.05)。Lo-gistic回归分析显示高Hcy水平、年龄、TC是CHD发生的独立危险因素,OR值[95%可信区间(CI)]分别为2.117(1.081～4.145)、1.105(1.070～1.142),1.023(1.005～1.042)(P均<0.05)。CBS 844ins68的OR值(95%CI)为1.254(0.229～6.867)(P>0.05)。结论高Hcy水平是我国北方汉族人2型DM合并CHD发生的独立危险因素。CBS 844ins68基因多态性不是2型DM合并CHD的危险因素。

Objective To explore the significance of the levels of homocysteine （Hcy） and the gene poiymorphisms of cystathionine 13-synthase （CBS） 844ins68 in type 2 diabetes mellitus （DM） with coronary heart disease （ CHD ） in Han nationality from Northern China. Methods The levels of plasma Hcy, folate, vitamin Bi2, total cholesterol（TC） , triglyefide（TG）, high density lipoprotein-cholesterol （ HDL-C）, low density lipoprotein-cholesterol （ LDL- C）, apolipoprotein A-I（ apo A-I） and apolipoprotein B （apo B） in 104 patients with type 2 DM and CHD, 127 patients with type 2 DM, 61 patients with CHD and 91 controls were determined. The gene polymorphisms of the CBS 844ins68 was determined by polymerase chain reaction （PCR）-based assay. Results The plasma Hcy levels in DM with CHD patients were significantly higher than in control group and DM patients, and the levels of plasma folate and Vitamin B12 were significantly lower than in control group and DM patients （P 〈 0.05 ）. The levels of Hcy, folate and Vitamin B12 in DM with CHD patients had not significant differences than those in CHD group （P 〉 0.05 ）. The levels of Hcy, folate and Vitamin B12 between in DM patients had not significant differences than those in control groups. There was no significant difference in the frequencies of CBS 844ins68 genotype and allele among 4 groups （ P 〉0.05 ）. Logistic-regression analysis indicated that hyperhomocysteinemia（ HHcy）, age, TC were the independent risk factors for CHD in type 2 diabetes, and OR [95% confidence interval （CI） ] were 2. 117 （ 1. 081-4. 145 ） , 1. 105 （ 1. 070-1. 142） , 1. 023 （ 1. 005- 1. 042 ） （ P 〈 0.05 ） , respectively. The OR（95 % CI） of CBS 844ins68 was 1. 254 （0. 229-6.867 ） （ P 〉 0.05 ）. Conclusions HHcy was the independent risk factor for DM with CHD, and the gene polymorphism of CBS 844ins68 was not the risk factor for DM and CHD in northern Chinese Han population.