钾离子内向整流通道蛋白基因多态性对格列美脲治疗高血压合并糖尿病降糖调脂的作用

Role of KCNJ11 gene polymorphism in reducing blood glucose and regulating blood lipids in glimepiride-treated hypertension with DM

目的探讨钾离子内向整流通道蛋白J亚单位11号成员(KCNJll)E23K基因多态性在高血压合并糖尿病的表达意义及其对格列美脲降糖调脂作用的影响。方法选择2型糖尿病患者300例,根据是否合并高血压分为糖尿病组125例和糖尿病合并高血压组(合并组)175例,同期纳入我院体检中心体检的100例健康者为对照组。检测KCNJ11 E23K基因型,合并组根据降糖效果进一步分为血糖控制良好组(良好组)107例和血糖控制不良组(不良组)68例。采用logistic回归分析,采用Spearman相关性分析。结果3组年龄、糖尿病病程、体质量指数、空腹血糖、餐后2 h血糖、胰岛素抵抗指数、胰岛β细胞功能、收缩压、舒张压、TC、TG、HDL-C、LDL-C、E23K基因型及等位基因比较,差异有统计学意义(P<0.05,P<0.01)。合并组K等位基因频率明显高于糖尿病组和对照组(63.14%vs 54.80%和47.50%,P<0.05)。糖尿病病程、体质量指数、胰岛素抵抗指数、胰岛β细胞功能、HDL-C偏低、K等位基因是发生2型糖尿病合并高血压的危险因素(P<0.05)。良好组空腹血糖、餐后2 h血糖、TC、TG水平明显低于不良组,HDL-C水平明显高于不良组(P<0.05,P<0.01)。合并组患者KK基因型及K等位基因与空腹血糖、餐后2 h血糖、TC、TG治疗前后差值的绝对值呈负相关(P<0.05)。结论KCNJ11 E23K基因的多态性与糖尿病合并高血压有关,携带K基因不利于糖尿病合并高血压患者的血糖血脂控制。

Objective To study the role of KCNJ11 E23K gene polymorphism in reducing blood glucose and regulating blood lipids in glimepiride-treated hypertension patients with DM.Methods Three hundred type 2 DM patients were divided into DM group(n=125)and DM+hypertension group(n=175)with 100 healthy persons undergoing physical examination in our center served as a control group.Their KCNJ11 E23K genotypes were detected.The patients in DM+hypertension group were further divided into good blood glucose control group(n=107)and poor blood glucose control group(n=68),their blood lipid levels were measured and compared.Results Significant differences were detected in age,duration of DM,BMI,fasting blood glucose,post-prandial 2 h blood glucose,insulin resistance index,islet β cell function,SBP,DBP,serum levels of TC,TG,HDL-C,LDL-C,ratio of E23K genotypes and allelic genes among the 3 groups(P<0.05,P<0.01).The frequency of allelic genes was significantly higher in DM+hypertension group than in DM group and control group(63.14%vs 54.80%,63.14%vs 47.50%,P<0.05).Duration of DM,BMI,IR index,isletβcell function,low serum HDL-C level and K allelic genes were the risk factors for type 2 DM with hypertension(P<0.05).The fasting blood glucose level,post-prandial 2 h blood glucose level,serum TC and TG levels were significantly lower while the serum HDL-C level was significantly higher in good blood glucose control group than in poor blood glucose control group(P<0.05,P<0.01).The KK genotype and K allelic gene were negatively related with the absolute values of fasting blood glucose,postprandial 2 h blood glucose,TC and TG(P<0.05).Conclusion KCNJ11 E23K gene polymorphism is related with DM+hypertension.It is not beneficial for DM patients with hypertension carrying K gene to control their blood glucose and blood lipids.