【摘要】 目的探讨血管紧张素转化酶(angiotensin-converting enzyme,ACE)基因插入/缺失(insertion/deletion,I/D)多态性在郴州地区汉族2型糖尿病患者中的分布及其与糖尿病血管病变的关系。方法病程大于2年的郴州地区汉族2型糖尿病患者168例,依据是否合并高血压(hypertension,HT)、糖尿病肾病(diabetic nephropathy,DN)和糖尿病视网膜病变(diabeticretinopathy,DR)等归类。采用PCR法确定其ACE基因多态性,高分辨彩超测量了其颈动脉内中膜厚度(carotid intima-media thickness,CIMT),分析了I/D多态性与HT、DN、DR和CIMT的关系。用Logistic回归分析探讨了CIMT增厚的危险因素。结果 ACE基因型在本组患者中分布为:DD型21.4%,ID型38.1%,Ⅱ型40.5%。3个基因型之间CIMT(P=0.001)、并发DN的比例(P=0.001)和合并HT的比例(P=0.005)有统计学差异。CIMT增厚的危险因素包括女性性别,DD基因型,并发DN和高龄。结论郴州地区汉族2型糖尿病患者ACE基因的D等位基因与HT、CIMT增厚及DN等血管病变正相关。CIMT增厚的危险因素包括女性,DD基因型,并发DN和高龄。更多还原

【Abstract】 Objective To determine the angiotensin- converting enzyme(ACE)insertion/deletion(I/D)polymorphism in Han ethnic patients with type 2 diabetes in Chenzhou area of Hunan province,and to assess the association between this polymorphism and blood pressure as well as diabetic nephropathy(DN),diabetic retinopathy (DR),and carotid intima - media thickness(CIMT).Methods 168 consecutive Hans Chinese type 2 diabetic patients from Chenzhou area with a diabetes duration of more than 2 years were enrolled and the patients were categorized depending on whether there is hypertension(HT),DN,and DR,PCR method to define their ACE genotype, high - resolution color ultrasonograph to measure the CIMT.glycolated hemoglobin A1c(GH bA1c),urine protein and lipids were measured.Compare the genotype distribution according to the presence or absence of HT, DN,DR and carotid intima thickening in these patients.Analysis the risk factors of carotid artery intima thickening with Logistic regression analysis.Results ACE genotype distribution in patients of this group are as follows: DD,21.4%;ID,38.1%;Ⅱ,40.5%.Among the three genotypes,CIMT has statistics difference(P = 0.00l). Among the patients with three kinds of genotype,the proportion of DN(P = 0.001) and HT(P = 0.005) complication is different significantly.Logistic regression analysis showed that the risk factors of carotid intima - media thickenning were feminine gender,ACE - DD genotype,DN and advanced age.Conclusion D allele is associated with macrovascular complications such as hypertension and carotid intima - "media thickenning and microvascular complications such as nephropathy in the patients with type 2 diabetes mellitus(type 2 - DM)in Chenzhou area. The risk factors of carotid intima- media thickening were the female gender,ACE - DD genotype,DN and advanced age.更多还原