【摘要】 目的了解2型糖尿病患者的外周血管病变与肾素-血管紧张素系统基因多态性之间的关系。方法以踝肱比值为诊断标准,入选老年2型糖尿病外周血管病变患者56例,非外周血管病变患者84例。了解患者临床资料,并检测血管紧张素转化酶I/D、血管紧张素Ⅱ1型受体A1166C、血管紧张素原M235T三个基因多态性,运用Logistic回归分析外周血管病变危险因素。结果两组间的基因型、等位基因频率分布差异无显著性;但在携带血管紧张素转化酶I/D的D等位基因人群中,病例组携带血管紧张素原M235T的T等位基因比例高于对照组。C反应蛋白、纤维蛋白原和血管紧张素原M235T进入回归方程。结论肾素-血管紧张素系统不同的基因多态性组合可能对2型糖尿病患者外周血管病变的发生发展造成影响。纤维蛋白原、C反应蛋白、血管紧张素原M235T是外周血管病变的危险因素。更多还原

【Abstract】 Aim To investigate the contribution of three renin angiotensin system(RAS)gene polymorphisms to the presence of peripheral vascular disease(PVD)in Chinese type 2 diabetes(T2DM)patients.Methods Amount to 385 consecutive T2DM patients were examined.Fifty-six of these were determined as PVD patients for their ankle brachial index(ABI)were less than 0.9.84 non-PVD individuals were enrolled as control group.The clinic parameters and the gene polymorphisms of angiotensin converting enzyme(ACE)I/D,angiotensin Ⅱ type 1 receptor(AT1R)A1166C and angiotensinogen(AGT)M235T were measured.Logistic analysis were used to study the relationship between the parameters and the risk of PVD.Results There were differences in fibrinogen(Fbg),serum creatinine(Scr)and high-sensitivity C-reactive protein(hs-CRP)between cases and controls.There were no significant differences in the genotypes and allele frequencies of the three RAS gene polymorphisms between two groups.However,in the T2DM patients with D allele of ACE I/D,the prevalence of PVD significantly increased when they had T allele of AGT M235T at the same time.Logistic regression analysis showed that Fbg,hs-CRP,and AGT M235T were the risk factors of PVD.Conclusion Inflammation factors such as hs-CRP and Fbg are involved in the development of PVD in the T2DM groups.Although the role of single gene polymorphism of RAS is limited,the interaction of the three RAS gene polymorphisms may have significant effect on the risk of PVD in T2DM patients.The individuals with T2DM presenting with D allele of ACE I/D are likely to have higher risk of PVD when they have T allele of AGT M235T at the same time.更多还原