MTP基因多态性对辛伐他汀治疗T2DM合并脂代谢紊乱患者调脂效果的影响

Effects of MTP Gene Polymorphism on the Lipid-regulating Effect of Simvastatin in the Treatment of T2DM Complicating with Lipid Metabolism Disorder

目的:探讨微粒体三酰甘油转运蛋白(MTP)基因多态性对辛伐他汀治疗2型糖尿病(T2DM)合并脂代谢紊乱患者调脂效果的影响。方法:选择2015年6-12月于我院住院治疗的T2DM伴高胆固醇血症患者120例,予盐酸二甲双胍缓释片、马来酸依那普利片和辛伐他汀片对症治疗。采用聚合酶链反应-限制性片段长度多态性分析法检测各患者MTP G493T基因型,采用AU400型全自动生化分析仪分别于治疗前和治疗后第4周检测其总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)和高密度脂蛋白胆固醇(HDL-C)水平,并分析患者不同基因型对血脂水平变化的影响。结果:120例患者中,MTP G493T GG、GT、TT基因型患者分别占61.67%、26.67%和11.67%,符合Hardy-Weinberg平衡(P>0.05)。治疗前,各基因型患者TC、TG、LDL-C、HDL-C水平比较,差异均无统计学意义(P>0.05)。经4周药物治疗后,TT基因型患者TC、LDL-C水平的降低幅度显著低于GG、GT基因型患者,差异有统计学意义(P<0.05);而GT基因型患者TC、LDL-C水平的降低幅度与GG基因型患者比较,各基因型患者TG、HDL-C水平的降低幅度比较,差异均无统计学意义(P>0.05);各基因型患者不良反应总发生率比较,差异亦无统计学意义(P>0.05)。结论:TT基因型患者应用辛伐他汀治疗后,其TC、LDL-C水平的改善情况较差;MTP G493T基因多态性可能与辛伐他汀治疗T2DM合并脂代谢紊乱患者的调脂效果相关。

OBJECTIVE：To investigate the effects of MTP gene polymorphism on the lipid-regulating effect of simvastatin in the treatment of T2DM complicating with lipid metabolism disorder. METHODS：120 T2DM inpatients with hypercholesterolemia were selected from our hospital during Jun. to Dec. 2015 and given Metformin hydrochloride sustained-release tablets,Enalapril ma-leate tablets and Simvastatin tablets. PCR-RFLP was used to detect MTP G493T genotype. The levels of TG,TC,LDL-C and HDL-C were detected by AU 400 automatic biochemistry analyzer before treatment and the 4th week after treatment. The effects of different genotype on the change of blood lipid level was analyzed. RESULTS：Among 120 patients,the patients with MTP G493T GG,GT,TT genotypes accounted for 61.67%,26.67% and 11.67%,respectively,meeting Hardy-Weinberg balance（P〉0.05）. Before treatment,there was no statistical significance in TC,TG,LDL-C and HDL-C among different genotypes（P〉0.05）. After 4 weeks of treatment,the decrease of TC and LDL-C in TT genotype patients were lower than that in GG and GT genotype,with statistical significance（P〉0.05）. There was no significant difference in the decrease of TC and LDL-C between GT and GG geno-type,the decrease of TG and HDL-C（P〉0.05）. There was no significant difference in the incidence of ADR among different geno-types（P〉0.05）. CONCLUSIONS：After simvastatin treatment,the improvement of TC and LDL-C in patients with TT genotype is poor. MTP G493T gene polymorphism may be associated with the lipid-regulating effect of simvastatin in the treatment of T2DM patients with lipid metabolism disorder.