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目的探讨血管紧张素原(angiotensinogen,AGT)基因多态性与2型糖尿病肾病(diabetic nephropathy,DN)的关系。方法于2009年6月至2010年1月采用以医院为基础的成组病例对照研究方法,对72例2型糖尿病肾病患者(病例组)和127例未并发DN的2型糖尿病患者(对照组)进行问卷调查和实验室检查。应用聚合酶链反应-限制性片断长度多态性(PCR-RFLP)技术进行AGT基因M235T多态性分析。结果病例组AGT基因TT基因型和T等位基因频率分别为72.2%和83.3%,均明显高于对照组(49.6%和66.9%),差异有统计学意义(P<0.01)。单因素logistic回归分析结果显示,AGT基因型与DN之间存在统计学关联,与MM基因型者相比,TT基因型的2型糖尿病患者发生DN的OR值为4.127(95%CI:1.327~12.834)。与M等位基因携带者相比,携带AGT T等位基因的2型糖尿病患者发生DN的OR值为2.471(95%CI:1.483~4.115),且经糖尿病家族史、糖尿病病程和高血压调整后二者间的统计学关联仍然存在。结论 AGT基因M235T多态性与DN相关,T等位基因与2型糖尿病患者合并肾病的高危险有关。
Objective To investigate the relationship between angiotensinogen (AGT) gene polymorphism and type 2 diabetic nephropathy (DN). Methods From June 2009 to January 2010, a hospital-based group-based case-control study was conducted in 72 patients with type 2 diabetic nephropathy (case group) and 127 patients with type 2 diabetes without DN (control group ) Conducted questionnaires and laboratory tests. The AGT gene M235T polymorphism was analyzed by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Results The frequency of TT genotypes and T allele of AGT gene in case group were 72.2% and 83.3%, respectively, which were significantly higher than those in control group (49.6% and 66.9%, respectively) (P <0.01). The results of univariate logistic regression analysis showed that there was a statistical correlation between AGT genotypes and DN. Compared with MM genotypes, the OR of DN with TT genotype in type 2 diabetic patients was 4.127 (95% CI: 1.327 ~ 12.834). In patients with type 2 diabetes carrying the AGT T allele, the odds ratio for occurrence of DN was 2.471 (95% CI: 1.483 to 4.115) compared to M allele carriers and was adjusted for family history of diabetes, duration of diabetes, and hypertension The statistical relationship between the latter two still exists. Conclusion The M235T polymorphism of AGT gene is associated with DN, and the T allele is associated with the high risk of nephropathy in type 2 diabetic patients.