血管紧张素Ⅱ的Ⅰ型受体基因多态性和胰岛素抵抗与2型糖尿病冠心病的关系

Association between the type Ⅰ angiotensin Ⅱ receptor(AT_1R) gene A1166C polymorphism and insulin resistance in patients with type 2 diabes

目的 探讨血管紧张素Ⅱ的Ⅰ型受体 (typeⅠangiotensinⅡreceptor,AT1R)基因A116 6C多态性和胰岛素抵抗 (insulinresistance ,IR)与 2型糖尿病 (type 2diabetesmellitus,DM2 )冠心病的关系。方法应用PCR -RFLP法 ,对 6 2例DM2合并冠心病 (CHD)患者 ,4 9例DM2 非合并CHD患者和 10 1例正常对照组人群的AT1R基因A116 6C多态性进行检测 ;以 -log(空腹血糖×空腹胰岛素 )作为IR指标。结果 DM2 合并CHD组与DM2 非合并组比较 :AT1R基因型频率的差异无显著性 (P >0 .0 5 ) ;合并CHD组C等位基因频率显著升高 (0 .0 81vs0 .0 2 1) P <0 .0 5 ;OR =4 .2 1,95 %CI :1.0 0— 17.6 0。DM2 合并CHD组与非合并CHD组相比 ,ISI(- 2 .0 1vs- 1.77)显著升高 (P <0 .0 1)。AT1R基因多态性各基因型之间IR指标无显著性差异 (P >0 .0 5 )。结论 AT1R基因A116 6C多态性参与中国汉族人群DM 2CHD的发病 ;AT1R基因A116 6C多态性与IR无相关性 ;AT1R基因 116 6C等位基因携带者不是通过IR的影响而参与DM2 CHD的发病。

Objective: To explore the association between the Type Ⅰ angiotensin Ⅱ receptor(AT 1R) gene A1166C polymorphism and insulin resistance(IR) in patients with type 2 diabetics(DM 2). Methods: Type Ⅰ angiotensin Ⅱ receptor(AT 1R) genotypes was investigated with PCR-RFLP techniques in 111 cases of DM 2 and 101 normal subjects. Usedlong(fasting blood glucose x fasting insulin) for insulin specific index(ISI). Results: No significant differences in genotype frequencies of AT 1R gene were found between DM 2 complicated with coronary heart disease(CHD) and that without CHD(P>0.05). The C allele frequency of AT 1R gene in DM 2 with CHD was higher than that in DM 2 without CHD (0.403 vs 0.204,P<0.05;0.597 vs 0.429,P<0.05). The ISI levels was very higher in DM 2 with CHD than in DM 2 without CHD (-2.01 vs -1.77,P<0.01).There was no significant differences in ISI levels were found between AT 1R genotypes and ACE genotypes. Conclusion: AT 1R gene A1166C polymorphism contributes to the development of CHD in DM 2 patients, but it is not an independent risk factor. There is no association between the genotypes of AT 1R A1166C polymorphism and IR in patients with DM 2 in Chinese.