血清Hcy水平及MTHFR基因多态性与2型糖尿病神经病变的相关性研究

Relationship between serum Hcy level,MTHFR gene polymorphism and peripheral neuropathy in type 2 diabetes mellitus

目的探讨血清同型半胱氨酸(Hcy)水平及亚甲基四氢叶酸还原酶(MTHFR)基因多态性与2型糖尿病周围神经病变的相关性。方法选取我院2019年1月~2021年3月治疗的2型糖尿病患者80例,按照是否发生糖尿病周围神经病变(DPN)分为对照组(未发生DPN)和观察组(发生DPN)。比较两组各基因型与等位基因比例,不同基因型血清Hcy水平及Hcy异常率,采用logistic回归分析不同基因型及血清Hcy水平与2型糖尿病神经病变的关系。结果与对照组比较,观察组的TT基因型占比更高(χ^(2)=16.177,P<0.001)、CC基因型占比更低(χ^(2)=11.013,P=0.001),且观察组不同基因类型的Hcy水平及Hcy异常率均显著高于对照组,差异均有统计学意义(均P<0.05);两组的等位基因分布比较,差异有统计学意义(χ^(2)=5.224,P<0.001)。logistic回归分析显示血清Hcy水平是2型糖尿病神经病变的独立危险因素(OR=1.377,P<0.001)。与CC基因型比较,TT基因型的OR值为6.681,CT基因型的OR值为1.035,提示MTHFR C677T基因型中的TT基因型可能会增加DPN的发病风险(P<0.05)。结论血清Hcy水平、异常率及TT基因型均可能是DPN的危险因素。

Objective To explore the relationship between serum homocysteine(Hcy)levels,methylenetetrahydrofolate reductase(MTHFR)gene polymorphisms and peripheral neuropathy in type 2 diabetic.Methods A total of 80 patients with type 2 diabetes in our hospital from January 2019 to March 2021 were selected and divided into control group(without DPN)and observation group(with DPN)according to whether diabetic peripheral neuropathy(DPN)occurred.The genotypes and allele ratios of the two groups were compared;the serum Hcy levels and abnormal rates of Hcy were compared between the two groups of different genotypes,and the relationship between the different genotypes and serum Hcy levels and type 2 diabetic neuropathy was analyzed by logistic regression.Results Compared with the control group,the proportion of TT genotype in the observation group was higher(χ^(2)=16.177,P<0.001),the proportion of CC genotype is lower(χ^(2)=11.013,P=0.001),and the Hcy level and abnormal rate of different gene types in the observation group were significantly higher than those in the control group(P<0.05);There was significant difference in the distribution of alleles between the two groups(χ^(2)=5.224,P<0.001).Logistic regression analysis showed that serum Hcy level was an independent risk factor for type 2 diabetes neuropathy(OR=1.377,P<0.001).Compared with CC genotype,the or value of TT genotype was 6.681 and that of CT genotype was 1.035,suggesting that TT genotype in MTHFR C677T genotype may increase the risk of DPN(P<0.05).Conclusion Serum Hcy level,abnormal rate and TT genotype may be the risk factors for DPN.