2型糖尿病合并非酒精性脂肪肝中医体质分布规律与基因多态性关系研究

Correlation study on TCM constitution rules and gene polymorphism of type 2 diabetes mellitus complicating non-alcoholic fatty liver disease

目的:探讨2型糖尿病(T2DM)合并非酒精性脂肪肝(NAFLD)患者中医体质分布规律及其与脂联素基因(ap M1)多态性的关系。方法:在184例宁波地区汉族人群(T2DM合并NAFLD95例,健康人群89名)中,采用PCR技术研究脂联素45位点的单核苷酸多态性(SNP),并运用体质九分法进行中医体质分型,描述其分布频数比,并用逻辑回归法分析中医体质与基因多态性的关系。结果:宁波地区汉族人群T2DM合并NAFLD患者中,ap M1+45有T/G的SNP存在,其等位基因分布与健康人群有显著差异(P<0.05),突变型(T/G、G/G)人群该病易感性增加(OR=1.947,95%CI[1.082,3.503])。NAFLD组人群中气虚质(46.3%)、痰湿质(32.6%)分布增多,与健康人群比较有显著差异(P<0.05),且气虚、痰湿质分布与突变型(T/G、G/G)的出现呈正相关。结论:脂联素基因+45位点T/G、G/G基因突变型人群T2DM合并NAFLD的易感性增加,随着突变型(T/G、G/G)分布增多,气虚、痰湿体质出现亦增多。

Objective: To investigate the correlation between TCM constitution rules and gene polymorphism of type 2 diabetes mellitus(T2DM) complicating non-alcoholic fatty liver disease(NAFLD). Methods: PCR was performed to identify the single nucleotide polymorphisms(SNP) at the adiponectin locus +45 among 184 Chinese Han people in Ningbo area, including 95 patients with T2 DM complicating NAFLD and 89 healthy volunteers. The subjects' TCM constitution were identified with Constitution Nine Point and their distribution frequency ratio were then described. The correlation between TCM constitution rules and gene polymorphism was analyzed with logistic regression. Results: SNP was found in T/G at ap M1+45, and its allele distribution was different from that in control group(P<0.05) in Chinese Han people of Ningbo region. Compared with the subject with T/T in SNP45, the patients with T/G and G/G at SNP45 had higher susceptibility to T2 DM complicating NAFLD(OR=1.947, 95%CI[1.082,3.503]). In the experimental group, qi deficiency constitution and phlegm dampness constitution respectively accounted for 45.26% and 29.47%, which were significantly higher than those in the control group(P<0.05). The distribution of both constitution was positively correlated with the appearance of T/G and G/G at SNP45. Conclusion: People with T/G and G/G at ap M1+45 have higher susceptibility to T2 DM complicating NAFLD. With the increasing of mutant(T/G and G/G), patients with qi-deficiency and phlegm-dampness quality increased.