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目的探讨TGF-β1基因T869C在CC/CT基因型糖尿病肾病中的危险因素或潜在保护性因素。方法采用双向性队列研究,包括回顾性病例和前瞻性病例两部分内容,对150例糖尿病肾病患者进行流行病学调查,调查内容包括血脂、肾功能、血糖、餐后2 h血糖、24 h尿白蛋白定量、性别、年龄、高脂血症病史、糖尿病病程、高血压病史、吸烟史及是否合并糖尿病视网膜病变等其他慢性并发症、血压、体质指数等,调查是在被调查者知情并获得同意的基础上进行的,回顾性病例采用检索患者资料,电话联系患者来院检测和填写表格等方法。多因素分析用Cox比例风险回归模型。结果 Cox回归结果显示TGF-β1基因T869C基因多态性、吸烟、高血压是糖尿病肾病的独立危险因素(P<0.05),生存曲线显示,随着糖尿病发病时间的延长,尤其在糖尿病发病10年后,患者糖尿病肾病的发病率也在明显升高。结论本次研究表明,患有DN的2型DM患者其平均病程为糖尿病病程(11.3±2.4)年,与没有DN对照组相比,病程明显长于对照组。随着糖尿病发病时间的延长,尤其在糖尿病发病10年后,患者糖尿病肾病的发病率也在明显升高。此外,TGF-β1基因T869C基因多态性、吸烟、高血压是糖尿病肾病的独立危险因素。因此笔者认为在有遗传倾向的人群中,找到后天引发疾病的环境因素危险因子并加以干预,则会对疾病的预防起到深远的意义。
Objective To investigate the risk factors or potential protective factors of TGF-β1 T869C in CC / CT diabetic nephropathy. Methods Two-way cohort study, including retrospective cases and prospective cases, was conducted to investigate the epidemiological characteristics of 150 diabetic nephropathy patients. The survey included blood lipid, renal function, blood glucose, blood glucose at 2 h postprandial, 24 h urine Albumin, sex, age, history of hyperlipidemia, duration of diabetes mellitus, history of hypertension, history of smoking, and other chronic complications such as diabetic retinopathy, blood pressure, body mass index and so on, the survey was informed and obtained Agreed on the basis of retrospective case retrieval of patient information, telephone contact with patients to hospital testing and fill in forms and other methods. Cox proportional hazards regression model was used for multivariate analysis. Results The Cox regression analysis showed that T869C polymorphism of TGF-β1 gene, smoking and hypertension were independent risk factors for diabetic nephropathy (P <0.05). The survival curves showed that with the prolongation of diabetes, especially in the 10 years after onset of diabetes After the patient’s incidence of diabetic nephropathy is also significantly increased. Conclusions This study shows that the average duration of diabetes mellitus with type 2 DM in patients with DN is 11.3 ± 2.4 years, which is significantly longer than that in controls without DN. With the increase of diabetes onset time, especially in the incidence of diabetes 10 years later, the incidence of diabetic nephropathy in patients is also significantly increased. In addition, TGF-β1 gene T869C polymorphism, smoking, hypertension are independent risk factors for diabetic nephropathy. Therefore, I believe that in the genetic predisposition of people to find the environmental factors that cause disease and acquired risk factors and intervention, it will play a far-reaching significance for the prevention of the disease.