中老年人群脂联素基因多态性与脑白质病变的关系

The relationship between adiponectin gene polymorphism and cerebral white matter lesions

目的：探讨在中老年人群中脂联素基因多态性与脑白质病变（WML）之间的关系。方法纳入2012年6月—2013年1月第三军医大学大坪医院神经内科811例中老年（≥50岁）住院患者的临床资料、血液学指标等进行横断面研究。根据头颅 MRI 检查结果及 Fazekas 评分标准诊断WML 并分组：诊断为 WML 者419例纳入观察组,非 WML 者392例纳入对照组。采用连接酶链反应对患者基因进行分型。应用多因素 logistic 回归分析脂联素基因多态性与 WML 关系。结果与对照组比,观察组平均年龄更大,冠心病、既往卒中史、高血压和糖尿病的比例更高,血浆 TC、高密度脂蛋白胆固醇（HDL-C）和载脂蛋白 A-Ⅰ浓度较低,空腹血糖浓度较高（P 值均〈0.05）。 rs7649121的AA、AT、TT 基因型、等位基因 A、T 频率在两组间的分布差异有统计学意义（P 〈0.01）。调整了年龄、性别、既往卒中史、冠心病、高血压、糖尿病和 HDL-C 后,相对 AA 基因型,AT 基因型和 TT 基因型仍是 WML 的独立危险因素；在显性模型中,AT/ TT 基因型患 WML 的风险是 AA 基因型的1.73倍。结论在中国中老年人群中首次发现,脂联素基因的 rs7649121位点与 WML 有关,T 等位基因是 WML 发生的易感基因。

Objective To investigate the association between adiponectin gene single nucleotide polymorphism（SNP） and white matter lesions（WML） in middle aged and elderly subjects. Methods From June 2012 to January 2013, the clinical data and blood indicators of 811 patients in the Neurology Department of Daping Hospital of Third Military Medical University were conducted a cross sectional study. The diagnosis of WML was made according to the MRI results referred to Fazekas standards. Four hundred and ninteen WML patients were included into study group and 392 patients without WML were included into control group. Genotyping was performed using ligase chain reaction. Multivariate logistic regression analyses were performed to examine the association of WML with SNP. Results The patients in study group were older, and showed significantly higher proportion of coronary heart disease （ CHD ）, prior stroke, hypertension, and diabetes mellitus, and higher levels of fasting blood glucose whereas lower levels of total cholesterol, high-density lipoprotein cholesterol （HDL-C） and apolipoprotein A-Ⅰ compared with those in control group （all P values 〈 0. 05）. The distribution of AA, AT, TT genotype and A, T allele frequency of rs7649121 was different between the two groups significantly. After adjustment for age, sex, prior stroke, CHD, hypertension, diabetes and HDL-C levels, AT and TT were associated with higher risk of WML independently. In dominant model, AT/ TT genotype was 1. 73 times more likely to have WML than AA genotype. Conclusions Among the middle aged and elderly subjects, the present study firstly find that rs7649121 in adiponectin gene may be associated with WML, and T allele is probably a susceptible allele of WML.