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目的 观察瘦素基因 5’非翻译区第 19位核苷酸 (nt+19)A→G变异与中国人 2型糖尿病患者脂代谢、体脂含量及分布的关系。方法 35 1例无亲缘关系中国人 (其中糖耐量正常者 188例 ,2型糖尿病 16 3例 )用聚合酶链反应 限制性片段长度多态性检测瘦素基因nt+19A→G变异。结果 在 2型糖尿病组中 ,该基因变异与男性的总胆固醇 (TC)水平及低密度脂蛋白 胆固醇水平相关(P值分别为 0 .0 0 36及 0 .0 0 2 2 ) ,与女性的腹部皮下脂肪截面积 (SA)相关 (P =0 .0 40 1)。应用协方差分析作体重指数校正后 ,无论是 2型糖尿病男性或女性亚组中 ,均可见GG纯合子具有较高的SA(P值分别为 0 .0 2 5 5及 0 .0 432 )。进一步用Logistic回归分析发现 :瘦素基因nt+19A→G变异与 2型糖尿病男性的SA(P =0 .0 0 0 5 )、腹部内脏脂肪截面积 (VA) (P =0 .0 2 86 )及TC(P =0 .0 2 6 2 )相关 ,在 2型糖尿病女性中与SA(P =0 .0 0 0 2 )及VA(P =0 .0 0 43)相关。结论 瘦素基因nt +19A→G变异影响中国人 2型糖尿病局部体脂分布 ,且主要影响腹部皮下脂肪的分布。
Objective To observe the relationship between the nucleotide variation (nt + 19) A → G in the 5 ’untranslated region of leptin gene and lipid metabolism, body fat content and distribution in Chinese type 2 diabetic patients. Method 35 One unrelated Chinese (188 with normal glucose tolerance and 163 with type 2 diabetes) was tested for nt + 19A → G mutation by polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP). Results In type 2 diabetes, the genetic variation correlated with total cholesterol (TC) and LDL cholesterol (P = 0.060 and 0.002, respectively) in males and females Abdominal subcutaneous fat cross-sectional area (SA) was correlated (P = 0.0401). After covariance analysis was used for body mass index correction, homozygous GG homozygotes were found to have high SA in either male or female subtypes of type 2 diabetes (P values were 0 .0255 and 0 .043, respectively). Logistic regression analysis further revealed that the nt + 19A → G mutation of leptin gene was associated with SA (P = 0.00005), abdominal visceral fat cross-sectional area (VA) in type 2 diabetic patients (P = 0. 0286 ) And TC (P = .02262) were associated with SA (P = 0.00002) and VA (P = 0.0303) in type 2 diabetic women. Conclusion The nt + 19A → G mutation of leptin gene affects the distribution of body fat in Chinese type 2 diabetic patients and mainly affects the distribution of subcutaneous abdominal subcutaneous fat.