【摘要】 目的研究维生素D受体(VDR)基因多态性与昆明地区2型糖尿病(T2DM)伴骨质疏松症的关系,探讨T2DM伴骨质疏松症发病的遗传易感因素。方法收集2017年6月至2019年1月在昆明市第一人民医院内分泌科住院的T2DM患者237例,(1)按骨密度结果分组为T2DM无骨质疏松组(61例),T2DM合并骨量减少组(111例),T2DM伴骨质疏松组(65例),采用PCR-RFLP技术,检测VDR基因型,比较3组患者以下指标间的差异:VDR基因型及等位基因频率,性别、年龄、糖尿病病程、血压、身高、体重、体重指数(BMI)、空腹血糖(FPG)、糖化血红蛋白(HbA1c)、血钙、血脂、血尿酸(UA)、维生素D浓度、雌激素、睾酮水平,超敏C-反应蛋白(Hs-CRP)、纤维蛋白原(FIB),口服葡萄糖耐量(OGTT)-0 h、2 h血糖,0 h、2 h胰岛素(INS)水平,胰岛素抵抗指数(HOMA-IR);(2)比较VDR不同基因型间骨密度的差异;(3)将VDR基因型及组间差异有统计学意义的指标进行多因素Logistic回归分析。结果 (1)昆明地区T2DM患者,VDR基因型以Bb型为主,占77.6%;(2)3组患者比较,VDR基因型频率及等位基因频率,差异无统计学意义(P> 0.05);(3)VDR 3种基因型比较,各部位的骨密度,差异无统计学意义(P> 0.05);(4)多因素Logistic回归分析显示:年龄,吸烟可进入回归方程,而VDR基因型未进入回归方程。结论 (1)昆明地区T2DM患者,VDR基因型以Bb型为主;(2)年龄,吸烟是昆明地区T2DM伴骨质疏松患者的独立危险因素,VDR(Bsm I)基因型与昆明地区T2DM伴骨质疏松症的遗传易感性无关。更多还原

【Abstract】 Objective To study the relationship between vitamin D receptor(VDR) gene polymorphism and type 2 diabetes mellitus(T2DM) with osteoporosis in Kunming area,and to explore the genetic susceptibility factors of T2DM with osteoporosis. Methods We selected 237 diabetic patients in the department of endocrinology of First People’s hospital of Kunming from June 2017 to January 2019.(1) The patients were divided into T2DM without osteoporosis group(61 cases),T2DM with osteopenia group(111 cases),and T2DM with osteoporosis group(65 cases) by bone mineral density results. PCR-RFLP technique was used to detect VDR genotypes,we compared the differences between the three groups of patients in following indicators: VDR genotype and allele frequency,sex,age,duration of diabetes,blood pressure,height,weight,body mass index(BMI),fasting plasma glucose(FPG),glycosylated hemoglobin(Hb A1 c),blood calcium,blood lipids,blood uric acid(UA),the concentration of vitamin D, estrogen and testosterone levels, allergic C-reactive protein( Hs-CRP),fibrinogen(FIB),oral glucose tolerance(OGTT)-0 h,2 h;0 h,2 h-insulin(INS) level and insulin resistance index(HOMA-IR).(2) The differences in the bone mineral density was compared between different genotypes.(3) The VDR genotypes and the indicators with statistical differences between groups were analyzed by multivariate logistic regression. Results （1） VDR genotype was given priority to with a Bb,accounting for 77.6% in patients with T2DM in kunming area.(2) VDR genotype frequency and allele frequency differences between the three groups had no statistical significance( P > 0.05).( 3) There was no significant difference in BMD between the three genotypes of VDR(P > 0.05)(P > 0.05).(4) Multivariate logistic regression analysis showed that age and smoking could enter the regression equation,but VDR genotype did not. Conclusions （1） The main VDR genotype of T2DM patients in Kunming was Bb( 2) Age and smoking were independent risk factors of T2DM patients with osteoporosis in Kunming. VDR(BSMI) genotype was not associated with the genetic susceptibility of T2DM patients with osteoporosis in Kunming.更多还原