晚期糖基化终末产物受体、肿瘤坏死因子-α以及骨保护素的基因多态性对2型糖尿病增生期视网膜病变的影响

Effects of advanced glycation end products receptor, tumor necrosis factor-α, gene polymorphism of osteoprotegerin on proliferative retinopathy of type 2 diabetes mellitus

目的探讨晚期糖基化终产物受体(AGER)、肿瘤坏死因子-α(TNF-α)以及骨保护素(OPG)基因的单核苷酸多态性(SNPs)对2型糖尿病(T2DM)人群发生增生期视网膜病变的影响。方法选取2019年1月至2020年9月在桂林医学院附属医院就诊的700例T2DM患者作为研究对象,将其分为非糖尿病视网膜病变(NDR)组(n=386)和增生期糖尿病视网膜病变(PDR)组(n=314)。收集临床基本资料,取患者外周血,用竞争性等位基因特异性PCR基因分型检测法检测两组患者外周血中AGER基因rs1800625位点、TNF-α基因rs1800629位点以及OPG基因rs3134069位点的基因型。用logistic多因素回归分析模型分析这3个基因的多态性对T2DM患者发生PDR的影响。结果两组患者临床指标的收缩压、胰岛素使用与否及肾小球滤过率(GFR)比较,差异有统计学意义(P<0.05)。排除以上混杂因素后,在显性模型下,rs1800625位点的AG+GG基因型和rs3134069位点的AA基因型均是PDR易感性的独立影响因素(P<0.05);两组rs1800629位点中的三种基因型比较,差异无统计学意义(P>0.05)。结论rs1800625位点以及rs3134069位点多态性对T2DM人群PDR的发生产生影响,可能是该人群发生PDR的独立影响因素。

Objective To investigate the effect of advanced glycation end products receptor(AGER),tumor necrosis factor-α(TNF-α)and single nucleotide polymorphisms(SNPs)of osteoprotegerin(OPG)on proliferative retinopathy in the type 2 diabetes mellitus(T2DM).Methods A total of 700 T2DM patients admitted to the Affiliated Hospital of Guilin Medical University from January 2019 to September 2020 were selected as the research subjects,and they were divided into non-diabetic retinopathy(NDR)group(n=386)and proliferative diabetic retinopathy(PDR)group(n=314).Collected basic clinical data,peripheral blood was drawn from the patients,and the kompetitive allele-specific PCR genotyping method was used to detect the genotype of the rs1800625 locus in the AGER gene,rs1800629 locus in the TNF-αgene and the rs3134069 locus in the OPG gene in the peripheral blood of patients of the two groups.Logistic regression analysis was used to analyze the effect of the three gene polymorphisms on proliferative retinopathy in T2DM patients.Results There were statistically significant differences in systolic blood pressure,insulin use and glomerular filtration rate(GFR)between the two groups(P<0.05).After excluding the above confounding factors,under the dominant model,the AG+GG genotype at the rs1800625 locus and the AA genotype at rs3134069 locus were the independent factors for PDR susceptibility(P<0.05).There were no statistically significant differences between the three genotypes at rs1800629 locus in the two groups(P>0.05).Conclusion The polymorphisms of rs1800625 and rs3134069 affect the occurrence of PDR in T2DM patients,which may be independent influencing factors of PDR in T2DM patients.