慢性阻塞性肺疾病伴营养不良患者瘦素受体基因Gln223Arg多态性研究

目的探讨瘦素受体基因Gln223Arg多态性与慢性阻塞性肺疾病伴营养不良的关系。方法观察158例COPD临床稳定期老年患者及108例健康对照者，并根据体重指数（BMI）、理想体重百分比（NW％）、三头肌皮皱厚度（TSF）、上臂中点臂围（MAC）、血清白蛋白（ALB）、总淋巴细胞（LYM）等营养参数，将COPD组分为营养不良组（COPD1组）66例，COPD非营养不良组（COPD2组）92例。用酶联免疫吸附试验（ELISA）法测定血清瘦素水平，采用聚合酶链式反应及连接酶检测反应方法（PCR—LDR）测定158例COPD患者与108例对照组的瘦素受体基因Gln223Arg多态性的基因型。结果COPD营养不良组Gln223Arg基因型GG、GA及AA的频率分别为0．924、0．061和0．015，G和A等位基因频率分别为0．955和0．045；COPD非营养不良组Gln223Arg基因型GG、GA及AA的频率分别为0．783、0．206和0．011，G和A等位基因频率分别为0．886和0．114；对照组Gln223Arg基因型GG、GA及AA的频率分别为0．769、O．222和0．009，G和A等位基因频率分别0．88和0．12；COPD1组Gln223Arg基因型及等位基因频率与COPD2组和对照组比较差异有显著性；COPD2组和对照组比较差异无显著性。不同基因表型血清瘦素水平GG型低于A／G型＋AA型（40．08±17．53ng／mLVS44．35±16．95ng／mL），但差异无统计学意义。结论瘦素受体基因Gln223Arg多态性可能与COPD营养不良有关。

Study on the leptin receptor gene Gln223Arg polymorphism in patients with chronic obstructive pulmonary disease accompanied by malnutrition

Objective To investigate the relationship between leptin receptor gene Gln223Arg polymorphism and mal- nutrition of patients with chronic obstructive pulmonary disease （COPD）. Methods 158 elderly patients with COPD in stable stage and 108 normal controls were studied. Nutritional parameters, including body mass index （BMI）, percentage of normal body mass （NM%）, triceps skin-fold thickness （TSF）, mid-upper arm circumference （MAC）, serum album （ALB）, total lymphocyte counts （LYM） in all cases, were evaluated, respectively. COPD patients were divided into malnutrition group （group 1） and non-malnutrition group （group 2） according to the nutrition parameter. Serum leptin levels were measured by ELISA. The frequencies of genotype and allele single nucleotide polymorphism of leptin receptor gene （Gln223Arg） were detected via with polymerase chain reaction-ligase detection reaction and compared. Results In patients of COPD with malnutrition, the frequencies of genotype GG, GA, and AA were 0.924, 0.061 and 0.015, re- spectively, while those in patients of COPD without malnutrition were 0.783, 0.206 and 0.011, respectively, while those in controls were 0.769, 0.222 and 0.009; The allele frequencies of G and A in patients of COPD with malnutrition were 0.955 and 0.045, while those in patients of COPD without malnutrition were 0.886 and 0.114, while those in controls were 0.88 and 0.12. Significant differences were detected in genotypes and allele frequencies of Gln223Arg between COPD 1 subjects, COPD 2 subjects and controls, but there was no obvious difference between COPD 2 subjects and controls. And there were no significant differences in leptin levels between GG, A/G and AA genotypes. Conclusion LEPR Gln223Arg polymorphism may associate with malnutrition of patients with COPD.