绝经后肾虚证与骨代谢、雌激素及ApoE基因多态性的相关性研究

The Correlations between the Kidney Deficiency Syndrome in Postmenopausal Women and Bone Metabolism and Estrogen and Apolipoprotein E gene polymorphism

目的:探讨绝经后妇女肾虚证与骨代谢、雌激素及载脂蛋白E(Apo E)基因多态性的内在联系。方法:以80例绝经后肾虚证妇女为研究对象,另设对照组65例,同步检测骨密度(BMD)、血钙(Ca)、雌二醇(E2),并运用聚合酶链反应—限制性片段长度多态性(PCR-RFLP)方法检测两组Apo E基因型和等位基因频率,对结果进行分类统计学分析。结果:肾虚组与对照组BMD比较,肾虚组髋关节股骨颈(Neck)、股骨大转子(Troeh)以及Wards三角(Ward)不同部位的BMD均较对照组显著降低,差异有非常显著性意义(P<0.01)。而各部位BMD大小分别为Neck>Troch>Wards,BMD变化表现出了一定规律。与对照组比较,肾虚组血钙、雌二醇(E2)较对照组显著下降(P<0.01),差异有显著性统计学意义(P<0.01)。肾虚组检测到5种基因型,对照组未检测到ε4/ε4基因型;肾虚组ε4等位基因频率显著高于对照组(P<0.05)。骨密度、血钙、雌激素与Apo E等位基因ε4频率之间存在相关性:骨密度与血钙、雌激素呈正相关,血钙与雌激素呈正相关,各部位BMD、血钙、雌激素的改变与ApoE等位基因ε4频率呈正相关。结论:绝经后妇女肾虚证与骨密度、血钙,雌二醇(E2)有直接相应变化的关系,骨密度、血钙测定值和雌激素的变化可作为观察肾虚证治疗效果的参考依据。ApoE等位基因ε4频率升高与绝经后妇女肾虚证相关,ApoE等位基因ε4可能是肾虚证的危险因子。

Objective：To evaluate kidney deficiency syndrome in postmenopausal women with bone mineral densit and blood calcium and Estrogen and apolipoprotein E（Apo E） gene polymorphism in internal relations.Methods：To 80 cases of kidney deficiency syndrome in postmenopausal women studied,a separate control group of 65 cases,simultaneous detection of BMD,blood calcium（Ca）,estradiol（E2）,and polymerase chain reaction-restriction fragment length polymorphism（PCR-RFLP） method for detection of two Apo E genotypes and allele frequencies,the results were statistically analyzed categories.Results：Compared with the control group,kidney group hip femoral neck（Neck）,greater trochanter（Troeh） and Wards triangle（Ward） in different parts of the BMD was significantly lower than the control group,the difference was very significant significance（P0.01）.The size of each part of BMD,respectively NeckTrochWards,BMD showed a certain rule changes.blood calcium and estradiol（E2） decreased significantly in the kidney deficiency group（P0.01）.There was a significant difference was significant（P0.01）.The kidney deficiency group was detected 5 genotypes,the control group was not detected ε4/ε4;the kidney deficiency group was significantly higher ε4 allele frequency（P0.05）.Bone mineral density,calcium,estrogen and Apo E ε4 allele frequency correlation between： bone mineral density and serum calcium,estrogen was positively correlated with estrogen serum calcium was positively related to all parts of BMD,serum calcium,estrogen ApoE allele ε4 with changes in frequency were positively correlated.Conclusion：Kidney deficiency syndrome in postmenopausal women with BMD,blood calcium,estradiol（E2） corresponding changes have a direct relationship between the measured values and the calcium changes in estrogen as a treatment of kidney deficiency syndrome observed reference.Increased frequency of ApoE ε4 allele and the associated kidney deficiency syndrome in postmenopausal women,ApoE ε4 allele may be a risk factor for kidney deficiency syndrome.