社区老年人维生素D受体基因多态性与慢性肾脏病和牙周病易感性的关系

Relationship between vitamin D receptor gene polymorphism and susceptibility of chronic kidney disease and periodontitis in community-dwelling elderly people

目的探讨社区老年人维生素D受体(VDR)基因多态性与慢性肾脏病(CKD)和慢性牙周炎(CP)易感性的关系。方法采用前瞻性研究法,选取2016年2月至2020年2月于德州市人民医院体检的德州市某社区汉族老年人作为研究对象,其中113例体检健康者作为对照组,98例单纯CKD患者作为CKD组,102例单纯CP患者作为CP组,96例CKD伴CP患者作为CKD伴CP组。比较4组研究对象一般资料,收集受试者双侧颊黏膜脱落细胞,提取和纯化DNA,采用限制性片段长度多态性聚合酶链反应技术测定VDR基因TaqⅠ、BsmⅠ和FokⅠ位点基因型和等位基因分布;采用非条件Logistic回归模型以OR及95%CI评价VDR基因多态性与CKD和CP发生风险关联性。结果 CKD组与对照组在VDR基因TaqⅠ位点和FokⅠ位点的基因型和等位基因分布频率比较,差异有统计学意义(P<0.05);CP组与对照组在VDR基因TaqⅠ位点和BsmⅠ位点的基因型和等位基因分布频率比较,差异有统计学意义(P<0.05);CKD伴CP组与对照组在VDR基因TaqⅠ位点的基因型和等位基因分布频率比较,差异有统计学意义(P<0.05);VDR基因TaqⅠ位点中t等位基因可增加老年人CKD、CP和CKD伴CP发病风险(P<0.05);VDR基因BsmⅠ位点B等位基因可增加老年人CP发病风险(P<0.05);VDR基因FokⅠ位点中f等位基因可增加老年人CKD发病风险(P<0.05)。结论社区老年人VDR基因多态性可能与CKD和CP存在关联,其中VDR基因TaqⅠ位点多态性可能为CKD所致CP危险因素。

Objective To investigate the relationship between vitamin D receptor(VDR) gene polymorphism and susceptibility of chronic kidney disease(CKD) and chronic periodontitis(CP) in community-dwelling elderly people. Methods In this study,the elderly of Han nationality in a community of Dezhou City who had a physical examination at Dezhou People’s Hospital from February 2016 to February 2020 were prospectively selected as the research object,including 113 healthy individuals(control group),98 CKD patients(CKD group),102 CP patients(CP group) and 96 patients with CKD and CP(CDK-CP group). DNA of oral mucosa exfoliative cells was extracted,and sequenced by restriction fragment length polymorphism. Genotype and allele distribution of TaqⅠ,BsmⅠ and FokⅠ of VDR gene were analyzed. After adjusting the confounding factors such as age,gender,body mass index(BMI),systolic blood pressure(SBP),and diastolic blood pressure(DBP) by unconditional Logistic regression model,OR and 95% CI were used to verify the association between VDR gene polymorphism and the risk of CKD and CP. Resluts The genotype and allele frequency of the VDR gene at TaqⅠ and FokⅠ loci showed significant difference between the CKD group and the control group(P<0.05). The genotype and allele frequency of the VDR gene at TaqⅠ and BsmⅠ loci showed significant difference between the CP group and the control group(P<0.05). The genotype and allele frequency of the VDR gene at TaqⅠ locus showed significant difference between the CKD-CP group and the control group(P<0.05). The allele at TaqⅠ locus of VDR gene would increase the risk of CKD,CP and CKD with CP in the elderly(P<0.05). The B allele at BsmⅠ locus of VDR gene would increase the risk of CP in the elderly(P<0.05). The f allele at FokⅠ locus of VDR gene would increase the risk of CKD in the elderly(P<0.05). Conclusion VDR gene polymorphisms may be associated with CKD and CP in the elderly in the community. The TaqⅠ loci polymorphism of VDR gene may be a risk factor for CP caused by CKD.