血清脂联素及Nrf2基因多态性与糖尿病足感染的关联

Association of serum adiponection and Nrf2 gene polymorphism with diabetic foot infection

目的探讨糖尿病足感染病原学特点和血清脂联素(APN)、白细胞介素-17(IL-17)、降钙素原(PCT)水平及核因子E2相关因子2外显子(Nrf2)基因多态性与感染的关联.方法选取2021年1月-2022年6月河南中医药大学第三附属医院收治的86例糖尿病足感染患者为感染组,95例糖尿病足未感染患者为非感染组,分析糖尿病足感染病原学特点,检测Nrf2基因rs6721961位点基因分布及血清APN、IL-17、PCT水平.结果86例糖尿病足感染患者共分离出91株病原菌,革兰阳性菌、革兰阴性菌及真菌占比分别为47.25%、40.66%及12.09%;感染组Nrf2基因rs6721961位点AA基因型及A等位基因频率均高于非感染组(P<0.05);感染组中度、重度患者AA基因型频率、A等位基因频率均高于轻度患者(P<0.05);感染组患者血清APN水平低于非感染组,血清IL-17、PCT水平均高于非感染组(P<0.05),且随着感染程度加重,血清APN水平逐渐降低(P<0.05),IL-17、PCT水平逐渐升高(P<0.05).结论Nrf2基因rs6721961位点AA基因型、A等位基因及血清APN、IL-17、PCT水平与糖尿病足感染的发生及感染程度具有密切关系,感染病原菌以革兰阳性菌及革兰阴性菌为主.

OBJECTIVE To explore the etiological characteristics of diabetic foot infection,observe the serum adiponectin(APN),interleukin-17(IL-17),procalcitonin(PCT),and analyze the association of gene polymorphisms of nuclear factor E2 related factor 2 exon(Nrf2)with the infection.METHODS A total of 86 patients with diabetic foot infection who were treated in the Third Affiliated Hospital of Henan University of Chinese Medicine from Jan 2021 to Jun 2022 were assigned as the infection group,and 95 patients who did not have diabetic foot infection were chosen as the non-infection group.The etiological characteristics of diabetic foot infection were analyzed,the genotypes and alleles at rs6721961 locus of Nrf2 gene and the serum APN,IL-17 and PCT levels were detected.RESULTS Totally 91 strains of pathogens were isolated from the 86 patients with diabetic foot infection,47.25%of which were gram-positive bacteria,40.66%were gram-negative bacteria,and 12.09%were fungi.The frequencies of AA genotypes and A allele at rs6721961 of Nrf2 gene were higher in the infection group than in the non-infection group(P<0.05).In the infection group,the frequencies of AA genotype and.A allele of the moderate,severe patients were higher than those of the mild patients(P<0.05).The serum APN level of the infection group was lower than that of the non-infection group,and the levels of serum IL-7 and PCT of the infection group were higher than those of the non-infection group(P<0.05);the serum APN level declined with the aggravation of infection(P<0.05),the levels of IL-17 and PCT were elevated(P<0.05).CONCLUSION The AA genotype and A allele at rs6721961 locus of Nrf2 gene,serum APN,IL-17 and PCT levels are closely associated with the incidence of diabetic foot infection and severity of infection.The gram-positive bacteria and gramnegative bacteria are dominant among the pathogens causing the infection.