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目的研究脂联素基因(ADIPOQ)单核苷酸多态性(SNP)+45与马来酸罗格列酮治疗2型糖尿病疗效的相关性。方法选取103例新诊断2型糖尿病患者,口服马来酸罗格列酮24周,并定期检测糖脂代谢相关临床指标,用聚合酶链式反应一限制性片段长度多态性方法检测脂联素基因SNP+45(T/G)多态位点。结果 (1)103例2型糖尿病患者中,TT、TG、GG 基因型频率分别为55.34%(57例)、35.92%(37例)、8.74%(9例),T、G 等位基因频率分别为73.30%、26.70%;(2)TG+GG 基因型患者的治疗有效率(56.41%)显著高于 TT 基因型患者(33.93%),(P=0.0295);多变量的 Logistic 回归分析发现基线糖化血红蛋白(HbA1c)和 ADIPOQ SNP+45是影响该药物治疗有效性的独立相关因素;(3)马来酸罗格列酮治疗24周,TT 基因型和 TG+GG 基因型患者的空腹血糖(FPG)、餐后2 h 血糖(2hPG)、HbA1c 和稳态模式评估法计算的胰岛素抵抗(HOMA-IR)水平均较基线时(13.1±0.4,14.0±0.5)显著降低(分别为4.6±0.4、4.7±0.4),差异有统计学意义;(4)24周各临床指标及其与基线的差值和脂联素基因 SNP+45无显著相关性。结论 ADIPOQ SNP+45(T/G)与马来酸罗格列酮治疗2型糖尿病患者的有效性相关,是该药物治疗有效性的主要决定因素之一,TG+GG 基因型患者的治疗有效率高于 TT 基因型患者。
Objective To investigate the relationship between ADPOQQ +45 and the efficacy of rosiglitazone maleate in type 2 diabetes mellitus. Methods A total of 103 patients with newly diagnosed type 2 diabetes mellitus were selected for oral administration of rosiglitazone maleate for 24 weeks. The clinical indexes of glucose and lipid metabolism were detected regularly. The level of lipids was detected by polymerase chain reaction-restriction fragment length polymorphism Supramolecular SNP + 45 (T / G) polymorphic loci. Results (1) The frequencies of TT, TG and GG genotypes in 103 type 2 diabetic patients were 55.34% (57 cases), 35.92% (37 cases) and 8.74% (9 cases) respectively. The frequencies of T and G alleles (73.30% and 26.70% respectively). (2) The treatment effective rate in patients with TG + GG genotype was significantly higher than that in TT genotype patients (56.41% vs 33.93%, P = 0.0295). Multivariate logistic regression analysis Baseline HbA1c and ADIPOQ SNP + 45 are independent factors that affect the effectiveness of the drug therapy. (3) Fasting blood glucose (FBG) in patients with TT genotype and TG + GG genotype after treatment with rosiglitazone maleate for 24 weeks FPG, 2hPG, HbA1c and HOMA-IR were significantly lower than baseline (13.1 ± 0.4 and 14.0 ± 0.5 respectively) (4.6 ± 0.4, 4.7 ± 0.4). (4) There was no significant correlation between each clinical index at 24 weeks and baseline difference and adiponectin gene SNP + 45. Conclusions The association of ADIPOQ SNP +45 (T / G) with the efficacy of rosiglitazone maleate in the treatment of type 2 diabetes mellitus is one of the major determinants of the efficacy of the drug. The treatment of patients with TG + GG genotype Efficiency is higher than TT genotype patients.