生长激素缺乏症患儿EIF2AK3基因单核苷酸多态性与重组人生长激素疗效的相关性研究

Correlation between single nucleotide polymorphism of EIF2AK3 gene and the efficacy of recombinant human growth hormone in children with growth hormone deficiency

目的探讨真核翻译始动因子2-α激酶3(EIF2AK3)基因单核苷酸多态性(SNP)与生长激素缺乏症(GHD)之间的相关性及EIF2AK3基因SNP位点不同基因型的GHD患儿应用重组人生长激素(rhGH)疗效的差异。方法应用实时荧光定量PCR对104例GHD患儿及269名身高正常对照儿童的EIF2AK3基因的5个SNP位点rs1805165(G>T)、rs13045(A>G)、rs867529(C>G)、rs11684404(T>C)、rs6547787(T>G)进行基因分型,其中55例GHD患儿接受rhGH治疗,收集其治疗后随访的身高、体重,探讨EIF2AK3基因SNP位点不同基因型的GHD患儿,应用rhGH治疗后疗效的差异。结果(1)EIF2AK3基因的SNP位点rs13045和rs867529与GHD的发生具有相关性(均P<0.05)。(2)经连锁不平衡分析发现EIF2AK3基因SNP位点rs1805165、rs13045、rs867529、rs11684404、rs6547787组成的单倍体型GACTG和GAGTT会增加GHD的发生风险,OR(95%CI)分别是2.05(1.33~3.17)、2.62(1.48~4.65)。而单倍体型GACTT和TGGCG会降低GHD的发生风险,OR(95%CI)分别是0.68(0.48~0.97)、0.36(0.23~0.57)。(3)分析rs13045和rs867529位点不同基因型与疗效关系,发现应用rhGH治疗后rs13045的3种基因型之间身高增长差异无统计学意义(P>0.05)。rs867529位点CG基因型与CC基因型相比,每30 d身高少增加0.099 cm(β=-0.099,95%CI-0.162^-0.018,P=0.016)。结论EIF2AK3基因SNP位点rs13045及rs867529与GHD的发生具有相关性。经rhGH治疗GHD患儿EIF2AK3基因多态性位点rs867529的CG基因型与CC基因型相比,身高增长降低,EIF2AK3位点rs867529基因型与生长激素疗效具有相关性。

Objective To investigate the association between single nucleotide polymorphism(SNP)of eukaryotic translation initiation factor 2-αkinase 3(EIF2AK3)gene in growth hormone deficiency(GHD),and to determine whether the polymorphisms in the EIF2AK3 of children with GHD associate with the efficacy of recombinant human growth hormone(rhGH)therapy.Methods Five SNPs of EIF2AK3 gene,including rs1805165(G>T),rs13045(A>G),rs867529(C>G),rs11684404(T>C),rs6547787(T>G)were selected and genotyped by a TaqMan probe method in 104 children with GHD and 269 normal height control children.Among them,55 children with GHD were treated with rhGH.The height and weight of each patient with GHD after rhGH treatment were collected.Finally,to investigate whether there were differences between the efficacy of rhGH in children with GHD and different genotypes of EIF2AK3 gene polymorphism.Results(1)The polymorphisms rs13045 and rs867529 of EIF2AK3 gene were associated with the occurrence of GHD(P<0.05).(2)The haplotypes GACTG and GAGTT composed of SNPs rs1805165,rs13045,rs867529,rs11684404,and rs6547787 of EIF2AK3 gene increased the risk of GHD with OR(95%CI)of 2.05(1.33-3.17)and 2.62(1.48-4.65),respectively.The haplotypes GACTT and TGCCG reduced the risk of GHD,with OR(95%CI)of 0.68(0.48-0.97)and 0.36(0.23-0.57),respectively.(3)After determination the relationship between different genotypes and efficacy of rhGH with rs13045 and rs867529,it was found that there was no significant difference in height gain between rs13045 genotypes after rhGH treatment(P>0.05).Compared with CC genotype,there was a less height gain of CG genotype at rs867529 by 0.099 cm for every 30 d(β=-0.099,95%CI-0.162--0.018,P=0.016).Conclusions The EIF2AK3 gene polymorphism(rs13045,rs867529)was associated with the occurrence of GHD.The height gain of CG genotype of rs867529 was lower than that of CC genotype in children with GHD treated with rhGH.The EIF2AK3 locus rs867529 genotype was associated with rhGH efficacy.