甘露糖结合凝集素基因多态性与2型糖尿病合并尿路感染易感性的关联

Association of mannose-binding lectin gene polymorphisms with susceptibility to urinary tract infection in patients with type 2 diabetes mellitus

目的探讨甘露糖结合凝集素(MBL)基因多态性与2型糖尿病(T2DM)合并尿路感染(URI)易感性的关系。方法选择2019年4月-2021年4月武汉理工大学医院内科收治的T2DM合并URI患者82例为研究组,同期T2DM未合并URI患者82例为对照组。收集URI患者中段尿液样本进行病原菌培养及鉴定,抽取患者入院治疗当天外周静脉血。采用限制性片段长度多态性聚合酶链反应(PCR-RFLP)进行MBL基因多态性分型。多因素Logistics回归分析T2DM合并URI的危险因素。结果T2DM并发URI患者中段尿样本共检出82株病原菌,其中大肠埃希菌45株,占54.88%;研究组MBL基因54位点GG基因型、G等位基因频率均高于对照组,AA基因型频率低于对照组(P<0.05);多因素Logistics回归分析结果显示,患病年限、留置尿管史和MBL基因54位点多态性为T2DM并发URI的危险因素(P<0.05)。结论T2DM合并URI患者感染病原菌以大肠埃希菌为主,患病年限、留置尿管史和MBL基因54位点多态性增加T2DM患者URI风险。

OBJECTIVE To explore the relationship between mannose binding lectin(MBL)gene polymorphisms and susceptibility to urinary tract infection(UTI)in patients with type 2 diabetes mellitus(T2 DM).METHODS A total of 82 T2 DM patients complicated with UTI who were treated in internal medicine department of Wuhan University of Technology Hospital from Apr 2019 to Apr 2021 were assigned as the study group,meanwhile,82 T2 DM patients who were not complicated with UTI were chosen as the control group.The midstream urine samples were collected from the patients with UTI so as to conduct the culture of pathogens,the isolated pathogens were identified,the peripheral venous blood specimens were collected from the patients on the day of hospitalized treatment.The MBL gene polymorphisms genotyping was carried out by polymerase-chain-reaction-restriction-fragment-length polymorphism(PCR-RFLP)assay.Multivariate logistic regression analysis was performed for risk factors for URI in the T2 DM patients.RESULTS Totally 82 strains of pathogens were isolated from the midstream urine samples of the T2 DM patients complicated with UTI,45(54.88%)of which were Escherichia coli.The frequencies of GG genotype and G allele at 54 locus of MBL gene were significantly higher in the study group than in the control group,while the frequency of AA genotype of the study group was significantly lower than that of the control group(P<0.05).The result of multivariate logistic regression analysis showed that the course of disease,history of urinary catheter indwelling and polymorphisms at 54 locus of MBL gene were the risk factors for the UTI in the patients with T2 DM(P<0.05).CONCLUSION E.coli is the predominant species of pathogen isolated from the T2 DM patients complicated with UTI.The course of disease,history of urinary catheter indwelling and polymorphisms at 54 locus of MBL gene may increase the risk of UTI in the T2 DM patients.