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目的探讨江西汉族人群对氧磷酶1(PON1)Q192R基因多态性与2型糖尿病(T2DM)合并牙周病的关系。方法采用聚合酶链反应(PCR)和DNA直接测序技术,检测64例正常人(N组)、61例单纯T2DM(DM组)患者、64例T2DM合并牙周病患者(DM+P组)PON1 Q192R基因型。分析江西地区汉族人群PON1 Q192R基因型和等位基因的分布特点,以及T2DM和T2DM合并牙周病的危险因素。结果 13组间临床资料比较:与N组比较,DM、DM+P组研究对象的平均年龄均显著偏高;DM组的体重指数(BMI)、总胆固醇(TC)、甘油三酯(TG)、空腹血糖(FPG)、糖化血红蛋白(Hb A1c)、收缩压(SBP)平均水平高于N组,而高密度脂蛋白(HDL)平均水平低于N组;DM+P组的TC、TG、FPG、Hb A1c、SBP平均水平高于N组,而HDL平均水平低于N组(P<0.05)。与DM组相比,DM+P组平均年龄约高7岁,SBP平均水平和吸烟率均高于DM组(P<0.05)。23组内不同性别临床资料比较:N组女性的TG平均水平和吸烟率低于男性(P<0.05);DM组女性的HDL平均水平高于男性,而吸烟率低于男性(P<0.05);DM+P组女性的BMI、Hb A1c平均水平均低于男性(P<0.05)。3PON1 Q192R基因多态性TT、CC、TC基因型频率和T、C等位基因频率在3组之间两两比较,P值均>0.05。4在N组和DM组的二分类Logistic回归分析中,年龄、TG、TCH、SBP的OR值均>1,为发生DM的独立危险因素;在DM组和DM+P组的二分类Logistic回归分析中,年龄、SBP和BMI的OR值均>1,而BMI的OR值<1,提示年龄和SBP是发生T2DM合并牙周病的独立危险因素,而BMI则有保护作用(以α=0.05为纳入标准,以α=0.1为剔除标准)。结论 1在其他因素存在的情况下,PON1 Q192R基因多态性不能作为T2DM合并牙周病的独立危险因素。2高年龄、高TG、高TC、高SBP是T2DM的独立危险因素;高年龄、高SBP是T2DM合并牙周病的独立危险因素,而BMI则是保护因素。
Objective To investigate the relationship between Q192R polymorphism of paraoxonase 1 (PON1) and periodontal disease in type 2 diabetes mellitus (T2DM) in Han nationality in Jiangxi province. Methods Sixty-two normal subjects (N group), 61 patients with simple T2DM (DM group) and 64 T2DM patients with periodontal disease (DM + P) were detected by polymerase chain reaction (PCR) Q192R genotype. To analyze the distribution of PON1 Q192R genotypes and alleles and the risk factors of T2DM and T2DM with periodontal disease in Han nationality in Jiangxi province. Results The clinical data of the 13 groups were compared: Compared with the N group, the average age of DM, DM + P group were significantly higher; the body mass index (BMI), total cholesterol (TC), triglyceride (TG) FPG, Hb A1c and SBP were higher than those in group N, while the average level of HDL was lower than that of group N. The levels of TC, TG, The average level of FPG, Hb A1c, SBP was higher than that of N group, while the average level of HDL was lower than that of N group (P <0.05). Compared with the DM group, the average age of DM + P group was about 7 years old, and the average SBP and smoking rate were higher than DM group (P <0.05). The clinical data of different sexes in group 23 were compared: the average level of TG and the smoking rate of women in group N were lower than those of men (P <0.05); the average level of HDL of female in group DM was higher than that of men (P <0.05) The average level of BMI and Hb A1c in DM + P group was lower than that in male (P <0.05). The frequencies of TT, CC, TC genotypes and T, C allele frequencies of 3PON1 Q192R gene polymorphism were compared between the three groups in any one pairwise and all P values> 0.05.4. Logistic regression analysis The OR of middle age, TG, TCH and SBP were all higher than 1, which were independent risk factors of DM. In the dichotomous Logistic regression analysis of DM and DM + P groups, the OR of SBP and BMI were all> 1, while OR of BMI was less than 1, suggesting that age and SBP were independent risk factors for periodontitis with T2DM. BMI had a protective effect (α = 0.05 was the inclusion criterion and α = 0.1 was the exclusion criterion). Conclusion1 PON1 Q192R polymorphism can not be an independent risk factor for periodontal disease in T2DM in the presence of other factors. High age, high TG, high TC and high SBP are independent risk factors for T2DM. High age and high SBP are independent risk factors for periodontitis with T2DM, while BMI is a protective factor.