血管紧张素转换酶基因rs4353多态性与糖尿病微血管病变的相关性研究

Association between angiotensin converting enzyme gene rs4353 polymorphism and diabetic microan-giopathy

目的 探讨血管紧张素转换酶（ACE）基因rs4353、rs4461142和rs8066114位点多态性与糖尿病微血管病变的相关性.方法 选择2016年1月至2017年1月在延安市人民医院治疗的675例2型糖尿病（T2DM）患者,按照是否合并微血管病变分为糖尿病视网膜病变（DR）＋/糖尿病肾病（DN）＋组130例、DR ＋/DN-组118例、DR-/DN＋组236例和DR-/DN-组191例.采用PCR-限制性片段长度多态性法检测ACE基因rs4353、rs4461142和rs8066114多态性,并收集患者一般病史资料及主要生化指标进行统计学分析.结果 与DR-/DN-组相比,DR ＋/DN＋组、DR ＋/DN-组、DR-/DN＋组GG基因型和G等位基因分布频率差异均具有统计学意义（x2=7.075 ～ 8.951,P均＜0.01）;各组rs4461142和rs8066114位点基因型和等位基因分布频率差异均无统计学意义（P均＞0.05）.多因素logistic回归分析结果显示,ACE基因rs4353位点G等位基因是糖尿病微血管病变的保护性因素（OR=0.715,95％ CI：0.418 ～ 0.923,P=0.007）.结论 对于T2DM患者ACE基因rs4353位点多态性可能与糖尿病微血管病变易感性相关.

Objective To investigate the association between angiotensin-converting enzyme （ACE） gene rs4353,rs4461142,rs8066114 polymorphism and diabetic microangiopathy.Methods A total of 675 patients with type 2 diabetes mellitus （T2DM） hospitalized in Yan＇an People＇s Hospital from January 2016 to January 2017 were recruited to participate in the study.According to their status of diabetic microangiopathy,they were divided into diabetic retinopathy （DR） ＋/diabetic nephropathy （DN） ＋ group （n =130）,DR＋/DN-group （n=118）,DR-/DN＋ group （n=236） and DR-/DN-group （n=191）.Genotype was determined by PCR-restriction fragment length polymorphism for the ACE gene rs4353,rs4461142 and rs8066114 polymorphism.Other general clinical data and biochemical indices were collected for statistical analysis.Results Compared with DR-/DN-group,the GG genotype and G allele frequencies of ACE gene rs4353 in DR ＋/DN ＋ group,DR ＋/DN-group and DR-/DN ＋ group were significantly different （x2 =7.075-8.951,all P 〈0.01）.However,the genotype and allele frequencies of rs4461142 and rs8066114 did not differ among four groups （all P 〉 0.05）.Multivariate logistic regression analysis showed that G allele of rs4353 was protective factor for diabetic microangiopathy （OR =0.715,95% CI：0.418-0.923,P =0.007）.Conclusion ACE gene rs4353 polymorphism may be closely related to the susceptibility of diabetic microangiopathy for patients with T2DM.