核因子E2相关因子2外显子基因多态性与糖尿病足感染易感性及严重程度的关联

Association between nuclear factor E2 related factor 2 exon gene polymorphism and susceptibility and severity of diabetic foot infection

目的 探讨核因子E2相关因子2外显子(Nrf2)基因多态性与糖尿病足感染(DFI)易感性及严重程度的关联。方法 选择滕州市中心人民医院内分泌科2020年1月-2021年1月收治的DFI患者75例为研究对象。选择同期医院进行治疗血糖控制达标的2型糖尿病患者70例为对照组。通过电子病历调取入组对象临床资料,DFI组患者根据疾病严重程度分为轻度组和中/重度组,针对Nrf2基因rs6721961位点设计特异性引物,采用聚合酶链式反应法扩增目的片段并经凝胶电泳观察基因分型。结果 DFI组AA基因型、A等位基因频率高于对照组,两组GG、GA基因型频率比较,无统计学差异,DFI组血清Nrf2水平低于对照组,差异具有统计学意义(P<0.05);中/重度组AA基因型高于轻度组,差异具有统计学意义(P<0.05),两组CC、CA基因型频率比较,无统计学差异,中/重度组血清Nrf2水平低于轻度组,差异具有统计学意义(P<0.05);Logistic回归结果显示携带Nrf2基因rs6721961位点AA基因型和A等位基因为DFI患者病情严重的危险因素(P<0.05)。结论 Nrf2基因rs6721961位点AA基因型显著增加本地区DFI易感性,为临床中针对性预防提供参考。

OBJECTIVE To explore the association between the nuclear factor E2 related factor 2 exon(Nrf2) gene polymorphism and the susceptibility and severity of diabetic foot infection(DFI). METHODS A total of 75 patients with DFI who were treated in endocrinology department of Tengzhou Central People’s Hospital from Jan 2020 to Jan 2021 were recruited as the study subjects, meanwhile, 70 type 2 diabetes mellitus patients who met the standards of blood glucose were set as the control group. The clinical data were acquired from electronic medical records. The DFI patients were divided into the mild group and the moderate/severe group according to the severity. The specific primers were designed for the rs6721961 locus of Nrf2 gene, the target fragments were amplified by polymerase chain reaction, and the genotypes were observed by gel electrophoresis. RESULTS The frequencies of AA genotype and allele A of the DFI group were higher than those of the control group, and there were no significant differences in the frequencies of GG and GA genotypes between the two groups. The serum Nrf2 level of the DFI group was significantly lower than that of the control group, and there was significant difference(P<0.05);the AA genotype of the moderate/severe group was significantly higher than that of the mild group(P<0.05), there were no significant differences in the frequencies of CC and CA genotypes between the two groups, the serum Nrf2 level of the moderate/severe group was significantly lower than that of the mild group, and there was significant difference(P<0.05). The result of logistic regression analysis showed that the AA genotype and allele A at rs6721961 locus of Nrf2 gene were the risk factors for severe condition of the DFI patients(P<0.05). CONCLUSION The AA genotype at rs6721961 locus of Nrf2 gene may remarkably increase the susceptibility to DFI, which provide guidance for targeted clinical prevention.