血管紧张素转换酶2和血管紧张素转换酶基因多态性与妊娠糖尿病孕妇及正常孕妇血脂水平的相关性研究

目的探讨血管紧张素转换酶2（ACE2）单核苷酸多态性位点rs2285666和rs2106809及血管紧张素转换酶（ACE）插入／缺失（I／D）多态性与妊娠糖尿病（GDM）孕妇及正常孕妇妊娠中晚期血脂水平的相关性。方法选取GDM孕妇344例，糖耐量正常（NOT）孕妇417例。采用聚合酶链反应（PCR）及聚合酶链反应-限制性片断长度多态性（PCR—RFLP）方法检测ACE2及ACE基因多态性，并于孕24～28周留取受试者空腹静脉血检测总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白胆固醇（HDLC）、低密度脂蛋白胆固醇（LDLC）、载脂蛋白A1（ApoA1）、载脂蛋白B（ApoB）和脂蛋白a[Lp（a）]水平。结果GDM和NGT两组间ACE2 rs2285666、rs2106809和ACE I／D基因型及等位基因分布频率均无统计学差异（P〉0．05）。GDM患者的TG水平显著高于NGT孕妇[（2．69±0．95）mmol／L vs（2．38±0．81）mmol／L]（P〈0．05），HDLC水平显著低于NGT孕妇[（2．11±0．46）mmol／L vs（2．20±0．43）mmol／L]（P〈0．05）。将受试者按ACE2 rs2285666、rs2106809ACE和ACE I／D基因型分组，ACE DD基因型组TC、LDLC水平高于ACEⅡ组，分别为（6．33±1．09）mmol／L vs（6．05＋0．96）mmol／L、（3．62±0．89）mmol／L vs（3．39±0．79）mmol／L（P〈0．05），进一步将受试者分别按ACE I／D基因型分组，NGT组DD基因型受试者TC和LDLC水平明显高于Ⅱ基因型组，分别为（6．46±1．20）mmol／L vs（6．06±0．95）mmol／L和（3．73±1．03）mmol／L vs（3．43±0．77）mmol／L（P〈0．05），而GDM组各基因型组之间各血脂水平无显著差异。结论ACE I／D多态性与孕妇孕中晚期血脂水平有关，NGT组DD基因型孕妇比Ⅱ基因型孕妇的TC、LDL水平高，GDM可能也存在ACE I／D多态性对孕妇妊娠中晚期血脂水平的影响。

Association of angiotensin converting enzyme 2 and angiotensin converting enzyme polymorphisms with lipid profiles in pregnant women with gestational diabetes mellitus or normal glucose tolerance

Objective： To investigate whether the angiotensin converting enzyme2（ACE2） single nucleotide poly- morphism rs2285666, rs2106809 and angiotensin converting enzyme （ACE） insertion/deletion （I/D） poly- morphism are associated with the lipid profiles in pregnant women with gestational diabetes mellitus （GDM） or normal glucose tolerance（NGT）.Methods： We recruited 344 pregnant women with GDM, 417 pregnant women with NGT. The ACE2 rs2285666, rs2106809 and ACE I/D polymorphisms were determined by polymerase chain reaction （PCR） or polymerase chain reaction-restriction fragment length polymorphism （PCR-RFLP）, and serum levels of total cholesterol （TC）, triglycerides （TG）, HDL cholesterol （HDLC）, LDL cholesterol （LDLC）, ApoA1, ApoB and Lp（a） were measured in all subjects during gestational age 24-28 weeks. Results. There was no significant difference in genotype and allele frequencies of ACE2 rs2285666, rs2106809 and ACE I/D polymorphism between GDM and NGT group（P〉0.05）. The TG level in GDM group was much higher than that in NGT group（2.69±0. 95 mmol/L vs 2.38±0. 81 mmol/L, P〈0. 05）, and HDLC level in GDM group was much lower than that in NGT group （2.11±0.46 mmol/L vs 2.20±0.43 mmol/L, P〈0.05）. When all subjects were divided into three groups according to ACE2 rs2285666 ,rs2106809 and ACE I/D SNP genotype, respectively, the TC, LDLC levels in ACE DD group were much higher than those in ACE II group （6.33 ±1.09 mmol/L vs 6.05±0.96 mmol/L and 3.62±0.89 mmol/L vs 3.39±0. 79 retool/L, P〈0.05） and there was no significant difference in lipid levels among other genotype groups. Furthermore, when GDM and NGT group were divided into three subgroups according to ACE I/D SNP genotype, respectively, NGT DD genotyped subjects had higher TC and LDLC level than NGT II genotyped subjects （6.46±1.20 mmol/L vs 6.06±0. 95 mmol/L and 3.73±1.03 mmol/L vs 3.43±0.77 mmol/L, P〈0.05）, whereas, there was no difference in lipid profile among each GDM ge