MBL2基因多态性与2型糖尿病并发老年外阴阴道炎复发感染的关联

Association between MBL2 gene polymorphisms and recurrence of vulvovaginitis in elderly patients with type 2 diabetes mellitus

目的 探讨可溶性甘露糖凝集素受体2(MBL2)基因多态性与2型糖尿病并发老年外阴阴道炎复发感染的关联。方法 选择绍兴市柯桥区妇幼保健院2019年1月-2021年1月因外阴阴道炎复发就诊的2型糖尿病老年患者97例为研究对象,将其分为高复发组46例和低复发组51例。针对MBL2基因第一外显子(exon 1)序列设计特异性引物,聚合酶链式反应扩增目的片段后在凝胶成像分析仪中观察分型结果;采用酶联免疫吸附法检测血清中MBL2水平。结果 研究对象总体以及60~<67岁、67~<74岁和74~≤80岁T2DM合并复发外阴阴道炎类型均以假丝酵母菌阴道炎发病率最高,各年龄段T2DM合并复发外阴阴道炎在不同类型阴道炎中发病率比较,无统计学差异;假丝酵母菌阴道炎、细菌性阴道炎、滴虫性阴道炎和非特异性阴道炎患者MBL基因多态性位点分布比较,无统计学差异;高复发组MBL2基因GAC/GAC基因型、GAC等位基因频率高于低复发组,差异具有统计学意义(P<0.05);两组GGC/GAC、GAC/GAC基因型频率比较,无统计学差异;高复发组RVVC患者MBL基因携带GGC/GGC、GGC/GAC、GAC/GAC基因型三组血清MBL水平总体比较差异具有统计学意义(P<0.001),其中GAC/GAC型高于GGC/GGC及GGC/GAC型,差异具有统计学意义(P<0.001)。结论 MBL2基因突变可能通过影响血清MBL2水平的方式增加外阴阴道炎复发频率,其中GAC/GAC基因型为易感基因型。

OBJECTIVE To explore the association between soluble mannose lectin receptor 2(MBL2) gene polymorphisms and recurrence of vulvovaginitis in elderly patients with type 2 diabetes mellitus. METHODS A total of 97 elderly type 2 diabetes mellitus women with recurrent vulvovaginitis who were treated in Keqiao Maternal and Child Health Hospital from Jan 2019 to Jan 2021 were recruited as the study subjects and divided into the high recurrence group with 46 cases and the low recurrence group with 51 cases. The specific primers were designed for the first exon(exon 1) sequence of MBL2 gene, the target fragments were amplified by polymerase chain reaction, the genotypes were observed by gel imaging analyzer, and the serum MBL2 level was detected by means of enzyme-linked immunosorbent assay. RESULTS The incidence of Candida vaginitis was the highest among the types of recurrent vulvovaginitis in the overall study subjects, the women aged between 60 and 67 years old, the women aged between 67 and 74 years old, and the women aged between 74 and 80 years old. There was no significant difference in the incidence of different types of vaginitis among the different age groups of T2 DM women complicated with vulvovaginitis. There were no significant differences in the MBL gene polymorphisms loci among the patients with Candida vaginitis, bacterial vaginitis, trichomonas vaginitis and non-specific vaginitis. The frequencies of MBL2 gene GAC/GAC genotype and GAC allele of the high recurrence group were significantly higher than those of the low recurrence group(P<0.05);there were no significant differences in the frequencies of GGC/GAC and GAC/GAC genotypes between the two groups;there was significant difference in the overall serum MBL level among the RVVC patients carrying with MBL gene GGC/GGC, GGC/GAC and GAC/GAC genotypes in the high recurrence group(P<0.001), and the overall serum MBL level of the patients carrying with GAC/GAC genotype was significantly higher than that of the patients carrying with GGC/GGC and GGC/GAC genotypes(P<0.001). CONCLUSION The MBL2 gene mutation may increase the frequency of recurrence of vulvovaginitis by affecting the serum MBL2 level, and the GAC/GAC genotype is the susceptible genotype.