2型糖尿病及糖耐量减低者外周血白细胞端粒长度及影响因素

Telomere length of peripheral white blood cells and its influencing factors in patients with type 2 diabetes mellitus or impaired glucose tolerance

[目的]探讨糖尿病发展过程中外周血白细胞端粒长度的变化及其影响因素。[方法]以2012—2014年上海市杨浦区市东医院招募的387例志愿者为研究对象,其中2型糖尿病(T2DM)患者65例、糖耐量减低(IGT)者112例、正常对照210例,进行问卷调查、体格检查和血液生化指标检测,提取外周血白细胞基因组DNA,采用实时荧光定量PCR法检测端粒长度。采用多元线性回归分析影响端粒长度变化的因素。[结果]T2DM组和IGT组的体质量指数、空腹血糖、餐后2h血糖、糖化血红蛋白均高于对照组,但其端粒相对长度分别为0.70±0.09和0.88±0.10,均低于对照组(1.06±0.22)(均P<0.05)。多元线性回归分析显示:T2DM组的年龄、体质量指数、空腹血糖和餐后2h血糖与端粒相对长度呈负相关(b=-0.042、-0.006、-0.037、-0.034,均P<0.05);IGT组的年龄和餐后2h血糖与端粒相对长度呈负相关(b=-0.041、-0.042,均P<0.05)。[结论]端粒长度缩短可能是T2DM发生的一个危险因素。端粒长度缩短不仅受到年龄和体质量指数的影响,而且受到血糖水平的影响。

[Objective] To study the change and influencing factors of telomere length of peripheral white blood cells in the development of diabetes mellitus.[Methods] A total of 387 volunteers were recruited from Shidong Hospital of Yangpu District from 2012 to 2014, including 65 type 2 diabetes mellitus （T2DM） patients, 112 impaired glucose tolerance （IGT） patients, and 209 control subjects. Questionnaire survey, physical examination, and blood biochemical test were conducted. DNA from peripheral white blood cells were extracted to measure telomere length by real-time fluorescence quantitative PCR. Multiple linear regression analysis was performed to analyze the factors influencing telomere length.[Results] The body mass index, fasting plasma glucose, 2-hour postprandial plasma glucose, and hemoglobin A1c in the subjects with T2DM or IGT were higher than those in the control subjects, while relative telomere length was shorter （T2DM patients：0.70±0.09, IGT patients：0.88±0.10, controls：1.06±0.22, P 〈 0.05）. The results of multiple linear regression analysis showed that age, body mass index, fasting plasma glucose, and 2-hour postprandial plasma glucose were negatively correlated with relative telomere length in the T2DM group （b=-0.042, -0.006, -0.037, -0.034, Ps 〈 0.05）, while age and 2-hour postprandial plasma glucose were negatively correlated with relative telomere length in the IGT group （b=-0.041, -0.042, Ps 〈 0.05）.[Conclusion] Short telomere length might be a risk factor of T2DM. Telomere shortening is affected not only by age and body mass index, but also by blood glucose level.