瘦素受体基因Gln223Arg变异对代谢综合征患者动态血压的影响

Influence of leptin receptor gene Gln223Arg variation on ambulatory blood pressure in patients with metabolism syndrome

目的探讨瘦素受体基因Gln223Arg变异与代谢综合征的相关性及其对动态血压的影响。方法选取来该院就诊的代谢综合征患者167例,健康体检者216例,均进行血压、动态血压、生化指标、胰岛素检查。以聚合酶链反应-限制性片段长度多态性（PCR-RFLP）行DNA多态性分析,电泳并测序判断瘦素受体基因Gln223Arg基因型。结果检测到AA、GG、AG 3种基因型。代谢综合征组携带A等位基因的频率显著高于对照组,携带A等位基因发生代谢综合征和发生血压节律呈非杓型的风险分别是携带G等位基因的3.302倍（P=0.000;95%CI：2.432~4.483）和2.506倍（P=0.000;95%CI：1.566~4.008）。AA基因型患者具有较高的体质量指数、血糖、血压、空腹胰岛素水平,血脂紊乱更严重,腰围更大,胰岛素抵抗指数更高。携带A等位基因的代谢综合征患者各项动态血压指标较高。结论瘦素受体基因Gln223Arg多态性A等位基因携带者发生代谢综合征的风险大,动态血压指标较高,并且更倾向于非杓型的血压节律。

Objective To investigate the correlation between leptin receptor（LEPR）gene Gln223 Arg variation with metabolism syndrome and its influence on ambulatory blood pressure.Methods Totally 167 patients with metabolism syndrome were selected and contemporaneous 216 individuals undergoing the physical examination were selected as the control group.The blood pressure,ambulatory blood pressure,biochemical indicators and insulin were detected in all the subjects.The DNA polymorphology analysis was performed by adopteint PCR-restricted fragment length polymorphism（RFLP）.The Gln223 Arg genotype was judged by electrophoresis and sequencing.Results Three genotypes of AA,GG and AG were detected.The frequency of carrying A alleles in the metabolism syndrome group was significantly higher than that in the control group.The occurrence risk of metabolism syndrome and non-dipper type blood pressure rhythm for carrying allele A was 3.302times（P=0.000;95%CI：2.432-4.483）and2.506 times of carrying allele G（P=0.000;95%CI：1.566-4.008）.The patients with AA genotype had higher BMI,blood pressure,blood glucose and fasting insulin levels,more serious dyslipidemia,greater waist circumference and higher insulin resistance index.The patients with metabolism syndrome carrying A allele also had higher ambulatory blood pressure indexes.ConclusionLEPR gene Gln223 Arg polymorphism A allele carrier has the great risk for metabolism syndrome occurrence,higher ambulatory blood pressure,moreover is more inclined to non-dipper type blood pressure rhythm.