非胰岛素依赖型糖尿病患者载脂蛋白E_2等位基因与肾功能不全及血脂水平的关系

The relationship of Apo E 2 and renal insufficiency lipid levels in NIDDM

目的研究非胰岛素依赖型糖尿病患者（ＮＩＤＤＭ）载脂蛋白（Ａｐｏ）Ｅ２等位基因与肾功能不全及血脂水平的关系。方法采用聚合酶链反应ＡＳＯ探针杂交技术检测１３０例ＮＩＤＤＭ患者及５０名正常人ＡｐｏＥ基因型。其中ＮＩＤＤＭ肾功能不全者４６例；非肾功能不全者８４例。结果肾功能不全患者中１０例为ＡｐｏＥ２；２８例为ＡｐｏＥ３／３。非肾功能不全患者中尿Ａｌｂ正常者５７例，其中６例为ＡｐｏＥ２，５１例为ＡｐｏＥ３／３。肾功能不全组ＡｐｏＥ２的出现频率为１３％，明显高于非肾功能不全组（５％）及正常人（５％）（Ｐ＜００５）；肾功能不全ＡｐｏＥ２组总胆固醇、甘油三酯水平分别为（５７±１０）ｍｍｏｌ／Ｌ及（５３±１７）ｍｍｏｌ／Ｌ，明显高于肾功能不全Ａｐｏ３／３组［分别为（４７±１２）ｍｍｏｌ／Ｌ及（２５±１２）ｍｍｏｌ／Ｌ］，及尿Ａｌｂ正常Ａｐｏ３／３［分别为（４５±１１）ｍｍｏｌ／Ｌ及（２４±１２）ｍｍｏｌ／Ｌ］、ＡｐｏＥ２组［分别为（４２±０８）ｍｍｏｌ／Ｌ及（２０±１１）ｍｍｏｌ／Ｌ］；肾功能不全ＡｐｏＥ２组高密度脂蛋白胆固醇明显低于其它３组。结论ＡｐｏＥ２等位基因与ＮＩＤＤＭ肾功能不全有?

Objective To study the relationship of ApoE2 and renal insufficiency, lipid levels in NIDDM patients. Methods PCR/ASO probe technique was used to determine ApoE genotypes. 46 NIDDM patients with renal insufficiency and 84 NIDDM patients without renal insufficiency as well as 50 healthy individuals were selected. Of the patients with renal insufficiency, 10 belonged to ApoE2 and 38 to ApoE3/3. In addition, 57 NIDDM patients with normoalbuminuria (6 with ApoE2,51 with ApoE3/3) were selected from the 84 NIDDM patients without renal insufficiency. Results Allele frequency was significantly higher in diabetic patients with renal insufficiency than in diabetic patients without renal insufficiency and in healthy individuals (P<005). Tc, TG levels were significantly higher in ApoE2 group with renal insufficiency than in E3/3 group with renal insufficiency, ApoE3/3 and ApoE2 groups with normoal buminuria. HDLc level was significantly lower in ApoE2 group with renal insufficiency than in other 3 groups. Conclusion ApoE2 is associated with renal insufficiency in NIDDM patients and that ApoE2 may be a factor that aggravates lipid abnormalities in NIDDM patients with renal insufficiency.