【摘要】 目的:分析肿瘤坏死因子α启动子区第308位G/A基因多态性与中国北方2型糖尿病患者胰岛素抵抗及血脂异常的相关性。方法:选择2003-08/2004-07伊春市第一医院内分泌科收治的2型糖尿病患者60例为对象,为2型糖尿病组,同期选取中国北方健康汉族人54例,为对照组。两组受试者均知情同意。应用放射免疫技术检测两组空腹血浆胰岛素和肿瘤坏死因子α水平。采用全自动生化分析仪检测两组空腹血糖、血浆总胆固醇、三酰甘油、低密度脂蛋白胆固醇和高密度脂蛋白胆固醇水平。采用稳态模型分析法评价胰岛素抵抗指数(胰岛素抵抗指数=空腹血糖×空腹血浆胰岛素/22.5)。采用聚合酶链反应-限制性片段长度多态性法检测两组肿瘤坏死因子α基因多态性。结果:纳入2型糖尿病患者60例和正常对照者54例,均进入结果分析。①2型糖尿病组血浆肿瘤坏死因子α、三酰甘油水平和胰岛素抵抗指数均高于对照组[肿瘤坏死因子α分别为(1.43±0.57),(1.21±0.42)μg/L;三酰甘油分别为(2.72±1.28),(1.62±0.79)mmol/L;胰岛素抵抗指数分别为4.60±0.98,3.28±0.67,P<0.05],高密度脂蛋白胆固醇水平低于对照组[(0.82±0.23),(1.01±0.19)mmol/L,P<0.05]。②2型糖尿病组和对照组携带GA+AA基因型的频率分别是0.316和0.093;A等位基因的频率分别是0.175和0.046。③2型糖尿病组携带GA+AA基因型胰岛素抵抗指数、肿瘤坏死因子α、三酰甘油水平高于携带GG基因型[胰岛素抵抗指数分别为5.24±1.25,4.07±0.89;肿瘤坏死因子α分别为(1.56±0.24),(1.39±0.37)μg/L;三酰甘油分别为(3.07±0.88),(2.18±1.08)mmol/L,P<0.05],而血浆总胆固醇、低密度脂蛋白胆固醇和高密度脂蛋白胆固醇水平两者比较差异无显著性。结论:肿瘤坏死因子α第308G/A基因突变与中国北方2型糖尿病患者的胰岛素抵抗及血脂异常有关。更多还原

【Abstract】 AIM: To investigate the correlation of tumor necrosis factor-alpha (TNF-α)-308G/A promoter polymorphism with insulin resistance and plasma lipoprotein abnormality of patients with type 2 diabetes mellitus in Northern China. METHODS: Altogether 60 patients with type 2 diabetes diagnosed and treated in Department of Endocrinology,Yichun First Hospital between August 2003 and July 2004 were selected as type 2 diabetes group,meanwhile,54 healthy Han persons were recruited as control group. All the examinees were agreed the experiment. The fasting serum insulin and TNF-α of the two groups were examined by immunoradiometric assay; fasting plasma glucose,total cholesterol (TC),triglyceride (TG),low and high density lipoprotein cholesterol (LDL-C,HDL-C) by automated biochemistry analyzer; insulin resistance index by Homeostasis model assessment (Insulin resistance index=fasting plasma glucose×fasting serum insulin/22.5); TNF-α promoter-308 gene polymorphism by polymerase chain reaction-restriction fragment length polymorphism techniques. RESULTS: All the 60 patients and 54 healthy persons were involved in the result analysis. ①Serum TNF-α,TG level and insulin resistance index in the type 2 diabetes group were higher than those of the control group [TNF-α: (1.43±0.57),(1.21±0.42) μg/L respectively; TG: (2.72±1.28),(1.62±0.79) mmol/L respectively; insulin resistance index: (4.60±0.98),(3.28±0.67) respectively; P < 0.05]; while the HDL-C was lower than the control group [(0.82±0.23),(1.01±0.19) mmol/L,P < 0.05]. ②Frequencies of GA+AA genotype in type 2 diabetes and control groups were 0.316 and 0.093 respectively; the frequencies of A allele were 0.175 and 0.046 respectively. ③The insulin resistance index,serum TNF-α and serum TG level of patients in the type 2 diabetes group with GA+AA genotype were higher than those of patients with GG genotype [Insulin resistance index were (5.24±1.25),(4.07±0.89) respectively; TNF-α were (1.56±0.24),(1.39±0.37) μg/L respectively; TG were (3.07±0.88),(2.18±1.08) mmol/L respectively; P < 0.05]; there was no significant difference in serum TC,LDL-C and HDL-C between the two groups. CONCLUSION: TNF-α gene 308G/A mutation was associated with insulin resistance and plasma lipoprotein abnormality of patients with type 2 diabetes mellitus in Northern China.更多还原