糖尿病肾病气阴两虚证与APOE、RAGE基因的关系

Correlation between Diabetic Kidney Disease with Qi-Yin deficiency Syndrome and APOE,RAGE Genes

目的研究糖尿病肾病(diabetic kidney disease,DKD)气阴两虚证易感性及病位、病性证素特征与APOE、RAGE多态性的相关性。方法通过对目标区域重测序分析,结合高通量测序技术和PCR技术,对需要检测的位点进行特异性引物设计,以不同的引物区分不同样本,应用单管PCR扩增并对扩增子进行高通量测序。使用生物信息学方法,区分测序结果中的不同样本,最后获得每个位点的突变信息。对224例DKD患者及100名健康人群进行APOE rs429358、RAGErs3134940基因分型。结果(1)气阴两虚组APOE rs429358风险基因型TT上的分布比例显著升高,总胆固醇(total cholesterol,TC),尿微量白蛋白(microalbuminuria,mALB)在TT基因型组较CC基因型组、CT基因型组显著升高(P<0.05)。病位证素肾在APOE rs429358风险基因型TT的分布比例显著升高,与非肾组相比较,差异具有统计学意义(P<0.05)。(2)气阴两虚组RAGE rs3134940风险基因型TT上的分布比例显著升高,低密度脂蛋白(low density lipoprotein cholesterin,LDL-C)在TT基因型组中显著升高,差异具有统计学意义(P<0.05)。病性证素痰在RAGE rs3134940风险基因型TT的分布比例显著升高,与非痰证组相比较,差异具有统计学意义(P<0.05)。结论在DKD气阴两虚证患者中,APOE rs429358风险基因型TT位点与肾小球病变可能存在相关,APOE rs429358风险基因型TT可能是DKD气阴两虚证患者影响肾的遗传学基础之一。携带RAGE rs3134940风险基因型TT的人群可能更易兼夹病性证素痰并易出现血脂异常。

Objective To explore the correlation between some elements in diabetic kidney disease(DKD)with Qi-Yin defi-ciency syndrome such as susceptibility,disease location and the nature of the disease with the polymorphism of APOE and RAGE genes.Methods A total of 224 cases of DKD patients and 100 healthy subjects were classified according to the APOE rs429358 and RAGE rs3134940 genes with the SNPscanTM technology.Results①The distribution ratio of APOE rs429358 genotype TT in Qi-Yin deficiency group was significantly increased.The levels of total cholesterol(TC)and urine micro-albumin(mALB)in TT genotype group was significantly higher than that in CC genotype group and CT genotype group(P<0.05).In APOE rs429358 Qi-Yin deficiency group,the kidney occupied a higher proportion in the TT gene type,and the difference was statisti-cally significant compared with that in the non-kidney deficiency group(P<0.05).②The distribution ratio of RAGE rs3134940 gene risk genotype TT in Qi-Yin deficiency group was significantly increased and the levels of low density lipoprotein-cholesterol(LDL-C)in TT genotype group were significantly higher than those in CC genotype group and CT geno-type group(P<0.05).In the RAGE rs3134940 Qi-Yin deficiency group,the phlegm occupied a higher proportion in the TT gene type,and the difference was statistically significant compared with that in the non-phlegm group(P<0.05).Conclusion 1.In DKD patients with Qi-Yin deficiency syndrome,APOE rs429358 gene risk gene TT may be associated with glomerular lesions,and may be one of genetic basis on the DKD patients with Qi-Yin deficiency syndrome affecting the kidney.2.People with RAGE rs3134940 genotype TT are liable to suffering from phlegm and dyslipidemia.