血管紧张素Ⅰ转换酶基因多态性与2型糖尿病心血管并发症关联研究

背景糖尿病晚期并发症的发生与遗传因素有关.有报道血管紧张素Ⅰ转换酶(angiotensinⅠ-converting enzyme,ACE)基因是糖尿病心血管并发症发生的风险因子.目的探讨ACE基因多态性与2型糖尿病心血管并发症之间的相关性.设计以2型糖尿病患者为研究对象的病例-对照研究.单位一所医学院的生物科学系普通生物学教研室.对象本研究于2001-02/2002-06在华北煤炭医学院分子生物学实验室完成.研究对象均为本医学院附属医院门诊及住院2型糖尿病患者,根据是否合并心肌梗死分为两组.心肌梗死患者组68例,其中男29例,女39例,年龄(65±3)岁;非心肌梗死组190例,其中男161例,女29例,年龄(60±1)岁.纳入标准均符合1985年WHO2型糖尿病诊断标准,心肌梗死诊断根据MRI确诊;排除标准资料不完整或不合作者.方法按常规酚/氯仿法提取基因组DNA,扩增产物用20mL/L琼脂糖凝胶电泳分析,溴化乙锭染色观察结果.对不同患者组等位基因和基因型频率进行比较.主要观察指标两组患者ACE基因的等位基因和基因型分布比较.结果2型糖尿病心肌梗死患者(64.7%)与非心肌梗死患者(55.0%)比较,DD纯合子频率显著增高(41.2%vs33.2%),差异具有显著性意义(x2=0.833,P＜0.05),D等位基因频率也显著增高,差异也具有显著性意义(x2=3.8491,P＜0.05).结论D等位基因和DD基因型是2型糖尿病心肌梗死发生的风险因子,这些指标的监测为糖尿病心肌梗死患者的二级康复预防和提高远期生活质量提供理论参考.

Correlation analysis between the genetic polymorphism of angiotensin I converting enzyme and the cardiovascular complications of type 2 diabetes

BACKGROUND: The occurrence of the late complications of diabetes is correlated with genetic factors. It has been reported that angiotensin I converting enzyme(AGE) gene is considered as the risk factor of the occurrence of the diabetic cardiovascular complications.OBJECTIVE: To investigate the correlation between the polymorphism of ACE gene and the cardiovascular complications of type 2 diabetes.DESIGN: A case-controlled study based on type 2 diabetic patients.SETTING: A laboratory of general biology,faculty of biology in a medical college.PARTICIPANTS: The study was conducted in the Molecular Biological Laboratory of North China Coal Medical College between February 2001 and June 2002. Type 2 diabetic patients selected from outpatient and inpatient departments of the affiliated hospital of our college were divided into two groups based on the complication of myocardial infarction. Myocardial infarction group(infarction group, n = 68) included 29 males and 39 females aged of(65±3) years old; non-myocardial infarction group(non-infarction group, n = 190) included 161 males and 29 females aged of(60±1) years old. Inclusion criteria: All patients were in accordance with WHO diagnostic criteria for type 2 diabetes set in 1985,and myocardial infarction was diagnosed by MRI; Exclusion criteria: Patients who had incomplete data or who were uncooperative.METHODS: Genome DNA was extracted by routine phenol/chloroform method. Amplified products were analyzed by 20 mL/L of agarose gel electrophoresis. The results were observed after ethidium bromide staining. The frequency of alleles and genotype was compared between two groups.MAIN OUTCOME MEASURES: The comparison of the distribution of ACE alleles and genotype in both groups of patients.RESULTS: DD homozygote frequency of type 2 diabetic patients complicated with myocardial infarction (64.7%) significantly increased to 41.2%(χ2 = 0. 833,P<0. 05) compared with 33.2% of patients without myocardial infarction (55.0%),while D allele frequency also significantly increased in patients with myocardial infarction as well (χ2 = 3. 849 1,P<0.05).CONCLUSION: D allele and DD genotype are risk factors of the occurrence of myocardial infarction in type 2 diabetes,and surveillance of these indicators provides theoretical references for the secondary rehabilitative prevention and the improvement of long term quality of life in diabetic patients complicated with myocardial infarction.