MTHFR基因多态性和脂蛋白磷脂酶A2在糖尿病周围血管病变中的分析

Analysis of MTHFR gene polymorphism and lipoprotein phospholipase A2 in diabetic peripheral vascular disease

目的分析糖尿病患者MTHFR基因多态性和脂蛋白磷脂酶A2(Lp-PLA2)水平变化与糖尿病周围血管病变的关系。方法选取东莞市康华医院及万江医院2016年12月至2019年8月收治的2型糖尿病患者60例与同期体检健康志愿者30例作为研究对象,其中糖尿病组又分为两个亚组:单纯糖尿病组(DM组)27例和糖尿病合并周围血管病变组(DM+PVD组)33例。检测三组患者的血清生化指标,并采用PCR-荧光法检测亚甲基四氢叶酸还原酶(MTHFR)基因型,分析它们与糖尿病PVD发生的关系。结果三组间血清TC、TG、HDL和LDL比较,差异均无统计学意义(P>0.05);DM+PVD组与DM组血清HbA1c、FPG与Lp-PLA2均明显高于健康组(P<0.05),且DM+PVD组血清Lp-PLA2水平高于DM组(P<0.05);DM+PVD组患者CC基因型比例低于健康组(P<0.05),而TT基因型比例和T等位基因频率均高于健康组和DM组(P<0.05),DM组与健康组间MTHFR基因多态性分布比较,差异无统计学意义(P>0.05)。经Logistic回归分析结果显示,DM患者PVD的发生与血清Lp-PLA2水平、MTHFR的TT基因型与T等位基因频率呈显著正相关,差异有统计学意义(P<0.05)。结论MTHFR基因C677T多态性与糖尿病患者PVD密切相关,且血清Lp-PLA2水平的升高可能参与了PVD的发生与发展。

Objective To analyze the relationship between the polymorphism of methylenetetrahydrofolate reductase(MTHFR)gene and the level of lipoprotein phospholipase A2(Lp-PLA2)in diabetic patients and the peripheral vascular lesions of diabetes mellitus.Methods A total of 60 patients with type 2 diabetes mellitus and 30 healthy volunteers for physical examination from December 2016 to August 2019 in Kanghua Hospital and Wanjiang Hospital of Dongguan City were selected as subjects.The diabetes group was divided into two subgroups:simple diabetes group(DM group)27 cases and diabetes mellitus with peripheral vascular disease group(DM+PVD group)33 cases.The serum biochemical indices of the three groups were detected,and the genotype of methylenetetrahydrofolate reductase(MTHFR)was detected by PCR-fluorescence technique.The relationship between MTHFR and diabetic peripheral vascular disease was analyzed.Results There was no significant difference in serum TC,TG,HDL and LDL among the three groups(P>0.05).Serum HbA1c,FPG and Lp-PLA2 in DM+PVD group and DM group were significantly higher than those in healthy group(P<0.05),and serum Lp-PLA2 level in DM+PVD group was higher than that in DM group(P<0.05);CC genotype proportion in DM+PVD group was lower than that in healthy group(P<0.05).However,TT genotype proportion and T allele frequency were higher than those of healthy group and DM group(P<0.05).There was no significant difference in MTHFR gene polymorphism between DM group and healthy group(P>0.05).Logistic regression analysis showed that the incidence of PVD in DM patients was positively correlated with TT genotype and T allele frequency of Lp-PLA2 and MTFR(P<0.05).Conclusion The C677T polymorphism of MTHFR gene is closely related to PVD in diabetic patients,and the elevation of serum Lp-PLA2 level may be involved in the occurrence and development of PVD.