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[目的]探讨ACE和AT1R基因多态性与2型糖尿病肾病的相互关系,从分子水平揭示发病机制。[方法]应用多聚酶链反应(PCR)结合限制性酶切技术,检测40例正常人和60例2型糖尿病患者ACE、AT1R的基因型和等位基因频率。[结果]①糖尿病(DM)组与糖尿病肾病(DN)组间的AT1R基因型构成和等位基因频率差异均无统计学意义(χ2=0.017,P﹥0.05;χ2=0.012,P﹥0.05)。DM组与DN组分别同对照组相比AT1R基因型构成差异均有统计学意义(χ2=8.40,P﹤0.01;χ2=7.06,P﹤0.01);等位基因频率差异也均有统计学意义(χ2=7.14,P﹤0.01;χ2=6.11,P﹤0.05);②DM组、DN组与对照组3组之间ACE基因型构成、等位基因频率差异均无统计学意义(P﹥0.05);③糖尿病肾病患者每分钟尿白蛋白排泄率与ACE和AT1R基因多态性可能无明显相关性(P﹥0.05)。[结论]ACE基因的DD基因型和D等位基因可能不是2型糖尿病及糖尿病肾病发生的危险因子;AT1R基因的C等位基因是2型糖尿病及糖尿病肾病发生的危险因子;D和C等位基因可能不是糖尿病肾病患者出现蛋白尿的危险因素。
[Objective] To explore the relationship between ACE and AT1R gene polymorphism and type 2 diabetic nephropathy and to reveal the pathogenesis from the molecular level. [Methods] The genotype and allele frequencies of ACE and AT1R in 40 normal subjects and 60 patients with type 2 diabetes mellitus were detected by polymerase chain reaction (PCR) and restriction enzyme digestion. [Results] ① There was no significant difference in AT1R genotypes and allele frequencies between diabetes mellitus and diabetic nephropathy (χ2 = 0.017, P> 0.05; χ2 = 0.012, P> 0.05) . There were significant differences in AT1R genotypes between DM group and DN group (χ2 = 8.40, P <0.01; χ2 = 7.06, P <0.01), and allelic frequencies also had statistical significance (χ2 = 7.14, P <0.01; χ2 = 6.11, P <0.05). ② There were no significant differences in ACE genotype and allele frequencies between DM group, DN group and control group (P> 0.05) ; Urinary albumin excretion rate per minute in patients with diabetic nephropathy ACE gene and AT1R polymorphism may not have significant correlation (P> 0.05). [Conclusion] DD genotype and D allele of ACE gene may not be risk factors of type 2 diabetes and diabetic nephropathy. C allele of AT1R gene is a risk factor of type 2 diabetes and diabetic nephropathy. D and C The bit gene may not be a risk factor for proteinuria in patients with diabetic nephropathy.