妊娠糖尿病患者血清TGF-β_(1)基因多态性预测产后T2DM发病风险相关性研究

Study on the correlation between serum TGF-β_(1) gene polymorphism and the risk of postpartum T2DM in patients with gestational diabetes mellitus

目的 探究妊娠糖尿病(GDM)患者血清转化生长因子-β_(1)(TGF-β_(1))基因多态性在预测产后2型糖尿病(T2DM)发病风险的价值。方法 选取保定市妇幼保健院1352例GDM患者,进行前瞻性研究,根据产后2年内是否发生T2DM分为T2DM组、无T2DM组。比较两组基线资料、TGF-β_(1)基因-509C/T和+869T/C位点多态性,分析TGF-β_(1)基因多态性与产后T2DM发病风险相关性。结果 完成随访的1346例GDM患者产后2年内T2DM发生率为6.17%(83/1346);T2DM组糖尿病家族史占比、产后口服葡萄糖耐量试验(OGTT)2 h、母乳喂养占比、产后胰岛素抵抗指数(HOMA-IR)均高于无T2DM组;基因分型检测结果显示,-509C/T位点基因型为CC、CT、TT,+869T/C位点基因型为TT、TC、CC,均存在多态性;产后OGTT 2 h、母乳喂养、产后HOMA-IR、+869T/C基因型TC、CC与C等位基因均是GDM患者产后T2DM发病的影响因素。结论 GDM患者产后T2DM发病与多种因素有关,其中TGF-β_(1)的+869T/C位点基因型TC、CC和等位基因C均会增加产后T2DM发病率,早期检测有助于临床预测GDM患者产后T2DM发病风险。

Objective To explore the value of genetic polymorphism of serum transforming growth factor-β_(1)(TGF-β_(1))in patients with gestational diabetes mellitus(GDM) in predicting the risk of postpartum type 2 diabetes mellitus(T2DM).Methods A prospective study was conducted on 1352 patients with GDM in Baoding maternal and child health hospital from September 2015 to August 2018. According to whether T2DM occurred within 2 years after delivery, they were divided into T2DM group and non T2DM group. The baseline data and polymorphisms of TGF-β_(1)gene-509C/T, +869T/C were compared between the two groups. The ccorrelation between TGF-β_(1)gene polymorphism and the risk of postpartum T2DM was analyzed by logistic regression equation. Results The incidence of T2DM in 1346 patients with GDM who completed the follow-up within 2 years after delivery was 6.17%(83/1346). The proportion of family history of diabetes, the 2 h postpartum oral glucose tolerance test(OGTT), the proportion of breastfeeding, and the postpartum insulin resistance index(HOMA-IR) in the T2DM group were all higher than those in the T2DM-free group(P<0.05). The genotyping test results showed that the genotypes at the-509C/T locus were CC, CT, TT, and the genotypes at the +869T/C locus were TT, TC, and CC, all of which were polymorphic. There was no statistically significant difference in the-509C/T genotype and allele distribution between the two groups(P>0.05), but the difference in the +869T/C genotype and allele distribution between the two groups was statistically significant(P<0.05). 2 h postpartum OGTT, breastfeeding, postpartum HOMA-IR, +869T/C genotype TC, CC and C alleles were all influencing factors of postpartum T2DM in GDM patients(P<0.05). Conclusion The incidence of postpartum T2DM in GDM patients is related to many factors. Among them, the +869T/C locus genotype TC, CC and allele C of TGF-β_(1)will increase the incidence of postpartum T2DM. Early detection can help clinically predict the risk of postpartum T2DM in GDM patients.