瘦素和瘦素受体基因多态性与肾移植术后糖尿病的相关性

Relationship between leptin and leptin receptor gene polymorphisms and diabetes after kidney transplantation

移植后糖尿病(post transplantation diabetes mellitus,PTDM)是肾移植术后最常见的并发症之一,发病率为10%~40%。遗传因素(如携带易感基因)是PTDM发生发展的一个重要危险因素。瘦素是一种脂肪细胞因子,其主要作用于下丘脑,诱导饱腹感。来自瘦素的信号输入与其他因素共同调节胰岛素敏感性,以保持能量平衡和血糖稳态。瘦素受体在瘦素信号通路中发挥必不可少的作用。瘦素和瘦素受体基因变异增加了PTDM发病风险,这两个基因突变通过改变胰岛素敏感性和胰岛β细胞分泌功能等机制影响血糖。本文介绍了瘦素及瘦素受体基因的结构和功能,回顾了近几年瘦素及瘦素受体基因在不同种族人群中与PTDM的风险相关性,对瘦素及瘦素受体基因变异造成PTDM的相关机制进行了探讨。

Post-transplant diabetes mellitus(PTDM) is one of the most common complications after renal transplantation, with an incidence of 10%~40%. Genetic factors such as carrying susceptibility genes are important risk factors for the occurrence and development of PTDM. Leptin is an adipocytokine that mainly acts on the hypothalamus and induces satiety. A large amount of evidence shows that the signal input from leptin regulates insulin sensitivity together with other factors to maintain energy balance and blood glucose homeostasis. Leptin receptors play an essential role in leptin signaling pathway. Recently, foreign studies have shown that leptin and leptin receptor gene mutations increase the risk of PTDM. These two gene mutations affect blood glucose by changing insulin sensitivity and islet β-cell secretion function. This work introduces the structure and function of leptin and leptin receptor genes, reviews the risk correlation between leptin and leptin receptor genes and PTDM in different ethnic groups in recent years, and discusses the mechanism of PTDM caused by leptin and leptin receptor gene variation.