肾移植患者低密度脂蛋白受体TaqⅠ位点基因多态性及血脂水平检测

目的 探讨肾移植患者脂代谢紊乱的一般特征及低密度指蛋白受体（LDLR）TaqⅠ基因多态性对血脂水平的影响。方法 选择105例肾移植患者为病例组，60例血脂正常的健康人作为对照。检测空腹血清总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白胆固醇（LDLC）、高密度脂蛋白胆固醇（DLC）、载脂蛋白及脂蛋白（a）Lp(a)]水平。采用聚合酶链反应－限制性长度片段多态性方法检测LDLR TaqⅠ基因多态性。结果 病例组于移植后3个月血脂水平即显著增高，于移植后6个月及1年时进一步升高；移植前血清TC、TG高于正常者仅占2.9%和7.6%，移植后3个月增高至28.6%和46.7%（P＜0.01）。移植后6个月升高至40.0%和59.0%，1年时升高至42.9%和62.9%，较3个月时显著升高（P＜0.05）。以TaqⅠ＋／－型人数最多，TaqⅠ＋／＋型最少；对照组Taq基因型分布与病例组的差异无显著性（P＞0.05）；不同基因型的受者血脂水平有所不同，多数指标依TaqⅠ－／－、TaqⅠ /-和TaqⅠ / 顺序递减；对照组因LDLR TaqⅠ基因型的不同，血清TC、LDLC水平的差异具有显著性，病例组除TC和LDLC外，TG、HDLC和Lp(a)的差异也有显著性。结论 肾移植术后易发生脂代谢紊乱，等位基因LDLR TaqⅠ是代谢紊乱发生的危险因子。

Detection of LDL receptor Taq I gene polymorphis m and serum lipid levels in renal transplantation recipients

Objectives To investigate the characteristics of lipid metabolism and the effect of low density lipoprotein receptor (LDLR) Taq I gene polymorphism on the blood lipid level in renal transplanted recipients.Methods Serum total cholesterol (TC), triglyceride (TG), LDL, high density lipoprotein, apolipoproteins and lipoprotein(a) were measured. Polymerase chain reaction- restriction fragment length polymophism (PCR-RFLP) was used to detect LDLR Taq I gene polymorphism.Results Serum lipid levels in the recipients at the third month after renal transplantation was increased significantly and higher at 6th month and the first year. The patients with the serum TC and TG levels beyond normal accounted for only 2.9% and 7.6% respectively before renal transplantation, but for 28.6% and 46.7% respectively at the third month after renal transplantation (P< 0.01), and for 40.0% and 59.0% respectively at 6th month. 42.9% and 62.9% for abnormal TC and TG at the first year were higher significantly than those at the third month after renal transplantation (P< 0.05). The data of LDLR Taq I polymorphism detected by PCR-RFLP showed that the numbers of three genotypes (+/-, -/-, +/+) were 60, 36, 9 in the recipients and 28, 25, 7 in controls, with the difference being not significant between the two groups (P> 0.05). The effect of three genotypes on serum lipid levels were different. The genotypes were associated with serum lipid levels of controls and patients in the following order:-/-, +/-, +/+, and more significant in the recipients.Conclusions Renal transplantation recipients are liable to be hyperlipidemia. LDLR Taq I gene polymorphism affects lipid metabolism in renal transplantation recipients to a certain extent.