小肠脂酸结合蛋白基因多态性与2型糖尿病合并冠心病的关系

Relationship between polymorphism of the human intestinal fatty acid binding protein gene and type 2 diabetic patients with coronary heart disease

目的 为了解小肠脂酸结合蛋白基因（ＦＡＢＰ２）多态性与２ 型糖尿病合并冠心病（ＣＨＤ）的关系。方法 ２ 型糖尿病无冠心病组（ＤＭ１）６４ 例，２ 型糖尿病合并冠心病组（ＤＭ２）８２ 例，非糖尿病冠心病组６２ 例，正常对照组６０ 例。应用聚合酶链反应（ＰＣＲ）技术检测２６８ 例对象ＦＡＢＰ２ Ｈｈａ Ｉ位点的限制性片段长度多态性（ＲＦＬＰｓ） 。结果 （１） 武汉地区汉族人存在ＰＡＢＰ２ ＨｈａＩ多态性位点，可产生Ｔｈｒ５４（ － ）和Ｔｈｒ５４（ ＋） 多态片段。（２）２ 型糖尿病合并冠心病患者ＦＡＢＰ２ Ｔｈｒ５４（ ＋） 基因型频率显著高于正常人（Ｐ＜ ０．０５）。（３）ＦＡＢＰ２ Ｔｈｒ５４（ ＋） 基因类型对２ 型糖尿病合并冠心病的参与风险率为２５ ．６ ％ ，比数比为２．１３（９５％ 可信限是１ ．０５ ～４．４５）。（４）２ 型糖尿病合并冠心病组含ＦＡＢＰ２Ｔｈｒ５４（＋ ）基因类型患者与含ＦＡＢＰ２ Ｔｈｒ５４（－ ）基因类型患者比较，空腹胰岛素水平显著增高（ Ｐ＜０．０１），胰岛素敏感指数显著下降（ Ｐ＜ ０．０５） 。（５）２ 型糖尿病合并冠心病组含ＦＡＢＰ２ Ｔｈｒ５４（＋ ）基因类型患者的血甘油三酯水平显著高于含ＦＡＢＰ２ ?

Objective To study the relationship between the human intestinal fatty acid binding protein gene (FABP2) and type 2 diabetic patients with coronary heart disease. Methods The polymorphism of 54th codon of FABP2 was determined with the PCR and RFLP methods in 268 subjects, inclnding 82 cases of type 2 diabetes with coronary heart disease (CHD), 64 cases of type 2 diabetes without CHD, 62 cases of non diabetic CHD and 60 normal controls. Results The polymorphic restriction site has been reported in the FABP2 identified by the enzyme Hha I in Han nationality in Wuhan. The frequency of genotype Thr54(+) significantly increased in the type 2 diabetic patients with coronary heart disease as compared with that in healthy subjects (P<0.05). There was no significant difference in the frequencies among coronary heart disease, type 2 diabetes, type 2 diabetic patients with coronary heart disease and the control groups, either in genotypes or in alleles. The attributable risk of FABP2 Thr54(+) genotype for the type 2 diabetic patients with coronary heart disease was 25.6%, and odds ratio was 2.13 (95% confidence interval is 1.05～4.45). The patients of Thr54(+) genotype with coronary heart disease had significantly higher fasting insulin level and plasma triglyceride value than those of Thr54(-) genotypepatientswithcoronaryheart disease (P<0.01,P<0.05). The patients of Thr54(+) genotype had significantly lower insulin sensitive index and lower high density lipoprotein cholesterol (HDL C) than those of Thr54(-) genotype in type 2 diabetic patients with coronary heart disease (P<0.05). Conclusions FABP2 gene polymorphism seems to be associated with the type 2 diabetic patients with coronary heart disease and their insulin resistance. FABP2 gene polymorphism also may be involved in the determination of lipoprotein profiles in the type 2 diabetic patients with coronary heart disease.