代谢综合征痰证不同脏腑病位与理化指标和CDKN2A基因的相关性研究

Correlation of phlegm in metabolic syndrome with physical and chemical indices and CDKN2A gene in different viscera

目的:研究代谢综合征(MS)痰证不同脏腑病位与理化指标和CDKN2A mRNA表达量的关联性,初步探讨MS痰证不同脏腑病位形成的生物学基础,为MS的辨证论治提供依据。方法:收集MS患者,运用证素辨证法从中筛选MS痰证单纯病位肝、脾、肾、肺、心患者各30例,并以30名健康人为对照。理化指标检测包括:身体质量指数(BMI)、甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、谷丙转氨酶(ALT)、谷草转氨酶(AST)、ALT/AST、谷氨酰转肽酶(GGT)、尿素氮(BUN)、尿酸(UA)及空腹血糖(FPG);实时荧光定量PCR法检测CDKN2A mRNA表达。结果:与健康组比较,MS痰证肝、脾、肾、肺、心组BMI、FPG均显著升高(P<0.01,P<0.05);AST/ALT显著降低(P<0.01);MS痰证脾、肾、肺、心组ALT均显著升高(P<0.01,P<0.05);MS痰证肾、肺、心组TG均显著升高(P<0.01);MS痰证肾、心组HDL-C显著下降(P<0.05,P<0.01),而GGT显著升高(P<0.01,P<0.05);MS痰证脾、肾组AST均显著升高(P<0.05,P<0.01)。与MS痰证肝组比较,MS痰证心组TG显著升高(P<0.05);MS痰证脾、肾组ALT、AST均显著升高(P<0.01,P<0.05);MS痰证肾、心组GGT显著升高(P<0.01,P<0.05);MS痰证肺组FPG显著降低(P<0.01)。与MS痰证脾组比较,MS痰证心组TG显著升高(P<0.05)。与MS痰证肾组比较,MS痰证肺组BMI、GGT、FPG均显著降低(P<0.05,P<0.01);MS痰证心组AST显著降低(P<0.05)。与MS痰证肺组比较,MS痰证心组FPG显著升高(P<0.01)。与健康组比较,MS痰证肝、脾、肾、肺、心组CDKN2A mRNA相对表达量均显著升高(P<0.05,P<0.01),MS痰证肝组CDKN2A mRNA相对表达量较其余病位组呈现升高趋势。MS痰证肝组CDKN2A mRNA表达与BMI、GGT、UA呈正相关(P<0.05);与HDL-C呈负相关(P<0.01);MS痰证肾组CDKN2A mRNA表达与BMI呈正相关(P<0.05)。结论:MS痰证不同脏腑病位的形成具有不同的物质基础。CDKN2A mRNA的高表达可能是影响MS痰证病位肝形成的生物学基础。MS痰证不同脏腑病位的临床理化指标与CDKN2A基因之间存在相关性。

Objective:To study the relationship between different zang-fu positions in sputum syndrome of metabolic syndrome(MS)and physicochemical indexes and CDKN2A mRNA expression levels,and to explore the biological basis of the formation of different zang-fu positions in sputum syndrome of MS,so as to provide evidence for syndrome differentiation and treatment of MS.Methods:MS patients were collected,30 cases of liver,spleen,kidney,lung and heart were selected by syndrome differentiation method,and 30 healthy people were used as controls.Physical and chemical indexes were detected including body mass index(BMI),triglyceride(TG),total cholesterol(TC),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),alanine transaminase(ALT),aspartate transaminase(AST),ALT/AST,γ-glutamyl transpeptadase(GGT),blood urea nitrogen(BUN),uric acid(UA)and fasting plasma glucose(FPG).Real-time fluorescence quantitative PCR was used to detect the expression of CDKN2A mRNA.Results:Compared with healthy group,BMI and FPG in liver,spleen,kidney,lung and heart groups with MS phlegm syndrome were significantly increased(P<0.01,P<0.05),AST/ALT was significantly decreased(P<0.01).ALT in spleen,kidney,lung and heart groups with phlegm syndrome was significantly increased(P<0.01,P<0.05).TG in kidney,lung and heart groups of MS phlegm syndrome was significantly increased(P<0.01),HDL-C was significantly decreased(P<0.05,P<0.01),and GGT was significantly increased(P<0.01,P<0.05)in MS phlegm-syndrome kidney and heart groups.AST in spleen and kidney groups with phlegm syndrome of MS was significantly increased(P<0.05,P<0.01).Compared with MS phlegm syndrome liver group,TG in MS phlegm syndrome heart group was significantly increased(P<0.05).ALT and AST in spleen and kidney groups with phlegm syndrome were significantly increased(P<0.01,P<0.05).GGT in kidney and heart groups with phlegm syndrome was significantly increased(P<0.01,P<0.05).FPG in MS phlegm-syndrome lung group was significantly decreased(P<0.01).Compared with MS phlegm-syndrome spleen group,TG in MS phlegm-syndrome heart group was significantly increased(P<0.05).Compared with MS phlegm-syndrome kidney group,BMI,GGT and FPG in MS phlegm-syndrome lung group were significantly decreased(P<0.05,P<0.01).AST in MS phlegm-syndrome heart group was significantly decreased(P<0.05).Compared with MS phlegm-syndrome lung group,FPG in MS phlegm-syndrome heart group was significantly increased(P<0.01).Compared with the healthy group,the relative expression level of CDKN2A mRNA in liver,spleen,kidney,lung and heart groups of MS phlegm syndrome was significantly increased(P<0.05,P<0.01),and the relative expression level of CDKN2A mRNA in liver group of MS phlegm syndrome was higher than that in other disease groups.CDKN2A mRNA expression was positively correlated with BMI,GGT and UA in MS phlegm-syndrome liver group(P<0.05).It was negatively correlated with HDL-C(P<0.01).There was a positive correlation between CDKN2A mRNA expression and BMI in MS sputum syndrome kidney group(P<0.05).Conclusion:The formation of different zang-fu diseases in MS phlegm syndrome has different material basis.The high expression of CDKN2A mRNA may be the biological basis of affecting liver formation in MS phlegm syndrome.There was a correlation between CDKN2A gene and clinical physicochemical indexes of different zang-fu diseases in MS phlegm syndrome.