人类白细胞抗原DRB基因型及其与妊娠期糖尿病的相关性研究

Study on the gestational diabetes mellitus and histocompatibility human leukocyte antigen DRB allele polymorphism

目的 探讨人类白细胞抗原 (humanleukocyteantigen ,HLA)DRB各基因型在妊娠期糖尿病 (GDM)孕妇中的分布 ,及其与GDM发病的相关性。方法 采用序列特异性引物聚合酶链反应技术 ,对GDM孕妇 30例 (GDM组 )及同期入院的正常健康孕妇 40例 (对照组 )的HLA DRB各基因型的分布进行检测 ,并对HLA DRB各基因型与GDM的相关性进行研究。结果 (1 )GDM组HLA DR6(1 3)等位基因频率 (1 2 % )明显高于对照组 (2 % ,P <0 0 5) ;GDM组HLA DR3(8% )及HLA DR9(2 3 % )等位基因频率与对照组 (4%、1 6 % )比较 ,均有增高趋势 ,但差异均无显著性 (P >0 0 5)。GDM组HLA DR2(1 5)和HLA DR51等位基因频率均为 1 0 % ,较对照组 (2 4 %、38% )明显降低 (P <0 0 5)。 (2 )孕妇为HLA DR3基因型或HLA DR6(1 3) /DR9基因杂合型时 ,其GDM病情较重 [风险比 (RR)分别为 2 7 1和8 5] ,且产后血糖多未恢复正常。结论 (1 )HLA DR6(1 3)基因型可能与GDM易感性相关 ;HLA DR2(1 5)、HLA DR51基因型可能与GDM保护性相关。 (2 )HLA DR3、HLA DR6(1 3) /DR9基因型与GDM病情严重程度有相关性 。

Objective To investigate the allelic frequency of histocompatibility leukocyte antigen (HLA) DRB of gestational diabetes mellitus (GDM) women,in order to find out the susceptible or protective gene associated with GDM and the relationship between HLA DRB genes and the clinical characteristic Methods Thirty GDM women served as study group, 40 normal pregnant women were selected as control group The distribution of HLA DRB alleles frequency of 30 GDM and 40 normalpregnant women was examed by polymerase chain reaction sequence specific primer (PCR SSP) Results There was significantly increased gene frequency of HLA DR6 (13) in GDM women compared with normal pregnancy (12% Vs 2%, P <0 05, RR =5 8) The frequency of HLA DR3 and HLA DR9 gene in GDM women were increased, but the statistical difference was not significant (8% Vs 4%, 23% Vs 16%, P >0 05) A much lower frequency of HLA DR2(15), HLA DR51 were observed in GDM women than in normal pregnancy (10% Vs 24%, P <0 05; 10% Vs 38%, P <0 05) There were relationship between HLA DR3 gene or HLA DR6 (13)/DR9 heterozygote and severe type of GDM, relative risk ( RR ) were 27 1 and 8 5 respectively; HLA DR6(13)/DR9 heterozygote or HLA DR3 gene were also correlated with abnormal plasma glucose levels Conclusions Alleles HLA DR6(13) were significantly implicated in their susceptibility to GDM Conversely, HLA DR2(15), HLA DR51 alleles might confer protection against GDM HLA DR3 gene and HLA DR6(13)/DR9 heterozygote were associated with severity and prognosis of GDM It may be a marker of grade and prognosis of GDM and may direct the treatment