维生素D受体基因多态性与急性胰腺炎临床转归的关联研究

Association study of vitamin D receptor gene polymorphisms and clinical outcome of acute pancreatisis

目的探讨维生素D受体(VDR)基因多态性与急性胰腺炎(AP)临床预后的相关性。方法共纳入AP患者508例,采用上海天昊生物科技有限公司改良的连接酶检测反应(imLDR)技术对VDR基因上14个单核苷酸多态性位点(SNPs)进行检测。非条件Logistic回归分析,校正年龄、性别、体质量指数、吸烟/饮酒状态、APACHE II评分后,在不同遗传模式下分析各位点基因型与AP患者临床转归(脓毒症/重症AP/死亡)的相关性。结果rs12721375 GA/AA基因型较GG发生脓毒症风险低(P=0.02);A等位基因型发生脓毒症的风险较G低(P=0.009)。rs2853559 GA和GA/AA较GG发生脓毒症风险高(P=0.022、0.026)。rs11168287 AA较GG和GG/GA发生重症AP风险高(P=0.030、0.022)。rs2853559 AA基因型较GG和GG/GA发生重症AP风险高(P=0.022、0.021)。rs11168283 CT/TT基因型较CC型发生死亡风险低(P=0.046)。结论VDR基因多态性与汉族人群AP患者临床转归相关,VDR基因参与了AP的进展过程。

Objective To investigate the relationship between vitamin D receptor(VDR)gene polymorphisms and the clinical prognosis of acute pancreatitis(AP),and to provide a genetic basis for early identification of critically ill patients.Methods A total of fourteen single nucleotide polymorphisms(SNPs)on the VDR gene were detected in 508 AP patients by using improved ligase detection reaction(imLDR)technology.Unconditional Logistic regression analysis was used to explore the association of VDR gene polymorphisms with outcome(sepsis/severe AP/death)of AP patients after adjusting for age,sex,body mass index(BMI),smoking and drinking status and APACHE II score under different genetic models.Results Rs12721375 GA/AA genotype had a lower risk of sepsis than GG(P=0.02)and the A allele had a lower risk of sepsis than G(P=0.009).Rs2853559 GA and GA/AA had higher risks of sepsis than GG(P=0.022 and 0.026 respectively).Rs11168287 AA had a higher risk of severe AP than GG and GG/GA(P=0.030 and 0.022 respectively).Rs2853559 AA genotype had a higher risk of severe AP than GG and GG/GA(P=0.022 and 0.021 respectively).The risk of death of rs11168283 CT/TT genotype was lower than that of CC(P=0.046).Conclusion VDR gene polymorphisms are related to the clinical outcome of AP patients in Chinese Han population.VDR gene is involved in the progression of AP.