酒精性肝硬化患者维生素D受体多态性与病理分期、肝功能的关系

Association of vitamin D receptor polymorphism with pathological stage and liver function in patients with alcoholic cirrhosis

目的探讨酒精性肝硬化患者维生素D受体(VDR)多态性与病理分期、肝功能的关系。方法选取江双大学附属湖北省第三人民医院2015年2月至2018年2月收治的酒精性肝硬化患者150例,根据患者病理组织学分期分为两组,分别为Ⅰ~Ⅱ期组(73例)、Ⅲ~Ⅳ期组(77例)。两组受检者均于入院当日检测VDR基因多态性。比较两组受检者的VDR基因型频率,采用Logistic回归模型分析VDR基因型频率是否为酒精性肝硬化病理进展的危险因素,并比较不同VDR基因型频率患者的肝功能指标,分析维生素D受体多态性与肝功能的关系。结果Ⅰ~Ⅱ期组bb基因型频率(56.16%)低于Ⅲ~Ⅳ期组(80.52%),Ⅰ~Ⅱ期组BB基因型频率(30.14%)高于Ⅲ~Ⅳ期组(7.79%),差异有统计学意义(P<0.05)。Ⅰ~Ⅱ期组的Child-PughA级、谷丙转氨酶<40U/L占比分别为35.62%、63.01%,高于Ⅲ~Ⅳ期组的15.58%、46.75%,差异均有统计学意义(P<0.05)。Logistic回归模型提示Child-PughC级、bb基因型频率、谷丙转氨酶≥40U/L是酒精肝硬化病理进展的独立危险因素(P<0.05)。bb型基因的血清谷丙转氨酶水平高于Bb、BB型基因,差异有统计学意义(P<0.05)。结论酒精性肝硬化患者病理进展、肝功能变化与维生素D受体多态性密切相关,其中bb基因型频率是其病理进展的危险因素。

Objective To investigate the relationship between vitamin D receptor(VDR)polymorphism and pathological stage and liver function in patients with alcoholic cirrhosis.Methods 150 patients with alcoholic cirrhosis admitted to our hospital from February2015 to February2018 were divided into two groups according to their histopathological stages:stageⅠ-Ⅱgroup(n=73)and stageⅢ-Ⅳgroup(n=77).The two groups were tested for VDR gene polymorphism on the day of admission.VDR genotype frequencies were compared between the two groups.Logistic regression model was used to analyze whether VDR genotype frequencies were risk factors for pathological progression of alcoholic cirrhosis.The relationship between vitamin D receptor polymorphism and liver function was analyzed by comparing the liver function indexes of patients with different VDR genotype frequencies.Results The frequency of BB genotype in stageⅠ-Ⅱgroup(56.16%)was lower than that in stageⅢ-Ⅳgroup(80.52%)and the frequency of BB genotype in stageⅠ-Ⅱgroup(30.14%)was higher than that in stageⅢ-Ⅳgroup(7.79%)(P<0.05).The proportion of Child-PughA,BB genotype frequency and alanine aminotransferase<40U/L in stageⅠ-Ⅱgroup were35.62%,30.14%and 63.01%,respectively,higher than those in stageⅢ-Ⅳgroup(15.58%,7.79%and 46.75%)(P<0.05).Logistic regression model suggested that Child-PughC grade,BB genotype frequency and alanine aminotransferase(>40U/L)were risk factors for pathological progression of alcoholic cirrhosis(P<0.05).The serum glutamic-pyruvic transaminase level of BB gene was higher than that of Bb and BB gene(P<0.05).Conclusion Pathological progress and liver function changes in patients with alcoholic cirrhosis are closely related to vitamin D receptor polymorphism,and BB genotype frequency is a risk factor for pathological progress.