PC-1基因K121 Q变异与2型糖尿病的关系

目的探讨浆细胞膜糖蛋白(PC-1)基因4号外显子K121Q多态性与2型糖尿病及临床特征的相关性.方法用聚合酶链反应-限制性内切酶片段长度多态性分析(PCR-RFLP)、DNA测序等技术检测上海地区汉族人群中165例2型糖尿病患者和98名正常糖耐量对照者PC-1基因K121Q的多态性分布情况,同时采用PCR-单链构像多态性分析(PCR-SSCP)筛查该区域其他可能与2型糖尿病发生有关的多态性位点.结果糖尿病患者中KK基因型143例(86.67%),KQ基因型22例(13.33%),QQ基因型0例(0.00%),K、Q等位基因频率分别为93.33%和6.67%;正常对照组中KK基因型85例(86.73%),KQ基因型12例(12.25%),QQ基因型1例(1.02%),K、Q等位基因频率分别为92.86%和7.14%,2组人群的基因型和等位基因频率差异无显著性(P＞0.05);2型糖尿病患者中Q等位基因携带者的胰岛素抵抗指数(IR)、血糖、胰岛素、血脂等均略高于KK基因型的患者,但两者之间的差异均无显著性;中国上海地区汉族人群Q等位基因频率明显低于欧洲白种人.结论目前尚不能确定PC-1基因K121Q多态性与上海地区汉族人群胰岛素抵抗及2型糖尿病发病相关;PC-1基因的K121Q多态性具有明显的种族差异.     

青岛地区糖尿病肾病患者PC-1基因K121Q和ACE基因DI多态性的研究

目的探讨浆细胞膜糖蛋白（PC-1）基因4号外显子K121Q多态性及血管紧张素转换酶（ACE）基因与2型糖尿病肾病的相关性分析,寻找与糖尿病发病相关的致病基因。方法用多聚酶链反应（PCR）结合限制性酶切技术检测青岛地区50例2型糖尿病患者和48例正常人的PC-1基因扣ACE基因的多态性分布情况。结果正常对照组中PC-1基因KK基因型38例（79．2％）,KQ基因型10例（20．8％）,QQ基因型0例（0．00％）,K,Q等住基因频率分别为89．6％和10．4％;糖尿病患者中KK基因型41例（82％）,KQ基因型9例（18％）,QQ基因型0例（0．00％）,K,Q等位基因频率分别为91％和9％,2组人群的基因型和等位基因频率差异无统计学显著性意义（P〉0．05）。正常对照组、糖尿病组、糖尿病肾病组之间ACE基因型构成、等位基因频率以及DD型与非DD型构成均无显著性差异。但ACE基因和PC-1基因对糖尿病肾病的发展进程存在协同作用。结论PC-1基因4号外显子K121Q多态性与2型糖尿病及2型糖尿病肾病无明显相关性,QQ基因型不是2型糖尿病及2型糖尿病肾病发病的危险因子;ACE基因DI多态性与2型糖尿病及糖尿病肾病无明显相关性,DD基因型不是2型糖尿病及糖尿病肾病发病的危险因子。     

PC-1基因K121Q变异与2型糖尿病的关系

目的探讨浆细胞膜糖蛋白(PC1)基因4号外显子K121Q多态性与2型糖尿病及临床特征的相关性。方法用聚合酶链反应限制性内切酶片段长度多态性分析(PCR RFLP)、DNA测序等技术检测上海地区汉族人群中165例2型糖尿病患者和98名正常糖耐量对照者PC1基因K121Q的多态性分布情况,同时采用PCR单链构像多态性分析(PCR SSCP)筛查该区域其他可能与2型糖尿病发生有关的多态性位点。结果糖尿病患者中KK基因型143例(86.67%),KQ基因型22例(13.33%),QQ基因型0例(0.00%),K、Q等位基因频率分别为93.33%和6.67%;正常对照组中KK基因型85例(86.73%),KQ基因型12例(12.25%),QQ基因型1例(1.02%),K、Q等位基因频率分别为92.86%和7.14%,2组人群的基因型和等位基因频率差异无显著性(P>0.05);2型糖尿病患者中Q等位基因携带者的胰岛素抵抗指数(IR)、血糖、胰岛素、血脂等均略高于KK基因型的患者,但两者之间的差异均无显著性;中国上海地区汉族人群Q等位基因频率明显低于欧洲白种人。结论目前尚不能确定PC1基因K121Q多态性与上海地区汉族人群胰岛素抵抗及2型糖尿病发病相关;PC1基因的K121Q多态性具有明显的种族差异。     

凝血因子Ⅶ基因R353Q多态性与脑梗死的相关性研究

目的 探讨我国汉族人凝血因子Ⅶ(FⅫ)基因第八外显子R353Q基因多态性分布及其与脑梗死的相关性.方法 应用聚合酶链反应-限制性片断长度多态性的方法 (PCR-RFLP),检测100例脑梗死患者及106例正常健康人FⅦ第八外显子R353Q各基因型及R、Q等位基因分布频率.结果 脑梗死人群中及正常健康人群中存在FⅦR353Q基因多态性分布,RR及RQ基因型在脑梗死组和正常对照组分布均符合Hardy-Weinberg平衡.脑梗死组中RR基因型91例,RQ基因型9例,QQ基因型0例,各基因型分布频率分别为91.00%(91/100)、9.00%(9/100)、0;R、Q等位基因频率分别为95.50%(191/200)和4.50%(9/200).健康对照组中RR基因型94例,RQ基因型12例,QQ基因型0例,基因型分布频率分别为88.70%(94/106)、11.30%(12/106)、0;R、Q等位基因频率分别为94.33%(200/212)和5.67%(12/212).脑梗死组与对照组之间整体基因型分布差异无统计学意义(χ20.3027,P=0.5822).R、Q等位基因在2组间的分布无统计学意义(χ20.2865,P=0.5925);Q等位基因携带者的频率在病例组与正常对照组的差异无统计学意义(χ20.2865,P=0.5925).结论我国汉族人群中存在凝血因子Ⅶ基因的R353Q多态性,不支持Q基因型是脑梗死的保护因子这一观点.     

核苷酸内焦磷酸酶磷酸二酯酶1 基因 K121Q 多态性与2 型糖尿病的相关性研究

目的探讨中国黑龙江汉族人群核苷酸内焦磷酸酶磷酸二酯酶1（Ecto—nucleotidepyrophosphatase／phosphodies-terase1,ENPPl）基因第4外显子K121Q对糖尿病发病的影响及其两者之间的关系。方法运用聚合酶链反应一限制性片段长度多态性（PCR—RFLP）方法检测146例2型糖尿病（T2DM）患者（T2DM组）和238例糖耐量正常对照健康人（对照组）EN—PPl基因K121Q的多态性分布,同时检测其临床及生化指标,进行随机对照研究。结果①T2DM组XQ（KQ＋QQ）基因型频率高于对照组（21．23％VS10．50％,P=0．0038）,其Q等位基因频率亦高于对照组（10．96％VS5．25％,P=0．0034）,差异有统计学意义;②携带Q等位基因个体与携带K等位基因个体两组比较,在性别构成、年龄、身高、体重、体重指数（BMI）l、腰围、臀围、腰臀比（WHR）、收缩压（SBP）、舒张压（DBP）、空腹血糖（FPG）、空腹胰岛素水平（FINS）、HOMA—IR差异均无统计学意义（P〉0．05）;（④Logistic回归显示,ENPPl基因K121Q多态性与T2DM相关（OR=2．30,95％CI=1．29—4．08,P=0．0038）;④汉族人群Q等位基因携带频率低于其他人群（非西班牙裔白人、美国黑人和西班牙人）。结论①ENPPl基因K121Q位点Q等位基因与中国黑龙江省汉族人群T2DM发病相关;②T2DM患者中携带Q等位基因个体无明显胰岛素抵抗表现;（~）ENPPl基因K121Q位点的多态性有明显种族地域差异性。     

KCNJ11基因单核苷酸多态性E23K突变与2型糖尿病(T2DM)遗传易感性的实验研究

目的探讨KCNJ11基因单核苷酸多态性E23K与2型糖尿病(T2DM)遗传易感性的关系。方法从2型糖尿病患者外周血有核细胞中提取基因组DNA,运用聚合酶链式反应扩增KCNJ11基因包含E23K多态性的DNA片断。将其扩增产物进行电泳分析,在紫外分析仪下观察结果并与正常人对照。结果2型糖尿病患者KCNJ11基因E23K的K等位基因频率(73.5%)显著高于对照组(6.7%)。KK基因型频率(72%)也显著高于对照组(2%)。K等位基因和KK基因型在两组中差异具有统计学意义(P<0.01)。结论提示KCNJ11基因单核苷酸多态性KK直接或间接与2型糖尿病遗传易感性相关。     

ABCAl基因R219K多态性在新疆维吾尔族、汉族分布特征及与血脂水平关系

目的:探讨三磷酸腺苷结合盒转运蛋白A1(ABCA1)基因R219K多态性在新疆汉族和维吾尔族健康人群中的分布特征及与血脂水平的相关性。方法:采用聚合酶链反应-限制性片段长度多态性技术,对新疆640名汉族和468名维吾尔族健康体检者的ABCA1基因R219K多态性进行检测,比较2个民族基因型和等位基因的分布特征,并分析ABCA1基因R219K多态性与血脂水平的相关性。结果:ABCA1基因R219K多态性位点在汉族和维吾尔族KK的基因型频率(20.5%,14.3%)、RK基因型频率(51.1%,51.5%)及RR基因型频率(28.4%,34.2%)比较差异均有统计学意义(P<0.05)。2个民族K等位基因频率(46.0%,40.1%)和R等位基因频率(54.0%,59.9%)比较差异有统计学意义(P<0.05)。2个民族KK、RK基因型携带者较RR基因型携带者血清三酰甘油水平降低(P<0.05),维吾尔族KK基因携带者,汉族KK、RK基因型携带者血清高密度脂蛋白胆固醇水平高于RR基因型携带者,差异均有统计学意义(P<0.05)。结论:ABCA1基因R219K多态性在新疆维吾尔族、汉族之间存在差异,且该多态性与血清...     

糖尿病、冠心病患者ABCA1基因R219K多态性的频率分布特点

目的旨在探讨我国北方地区汉族人ABCA1基因R219K多态性的频率分布特点,对血脂水平的影响,及其与冠心病、糖尿病和糖尿病合并冠心病的关系。方法采用改良碘化钠法提取基因组DNA,聚合酶链反应限制性片段长度多态性（PCR-RFLP）法分析ABCA1基因R219K多态性。结果正常对照组ABCA1基因R219K多态性RR、RK、KK基因型频率、R等位基因频率、K等位基因频率分别为28.5%、48.6%、22.9%、52.8%、47.2%;糖尿病组分别为29.6%、63.9%、6.5%、61.5%、38.5%;冠心病组分别为44.7%、44.7%、10.6%、67.0%、33.0%;糖尿病合并冠心病组分别为30.5%、61.9%、7.6%、61.4%、38.6%。疾病组ABCA1基因R219K多态性基因型分布与对照组有显著差异。结论 ABCA1基因R219K多态性极大的影响了血清HDL-C水平,K等位基因携带者HDL-C水平明显高于RR基因型。糖尿病组、冠心病组和糖尿病合并冠心病组ABCA1基因R219K多态性基因型分布与正常对照组有显著差异。K等位基因与冠心病的患病风险有一定关系。     

CYP1182-344T/C基因多态性与2型糖尿病肾病的关系

目的:研究2型糖尿病(T2DM)患者CYPlIB2.344T/C基因多态性与糖尿病肾病(DN)的相关性以及与DN不同分期的关系.方法:将145例12DM患者分为DN组73例和糖尿病非肾病组(NDN组)72例,另选择52例门诊体验健康人为正常对照组(NC组).应用聚合酶链反应一限制性内切酶片段长度多态性(PCR-RFLP)对以上197例观察对象进行基因型分析.结果:(1)DN患者存在CYPllB2-344T/C多态性.本研究197例观察对象中CYP11B2-344T/C多态性存在CC、CT、TT3种基因型,频率分别为12.7%、50.3%、37.1%;C、T等位基因频率分别为31.2%、68.8%.(2)DN组CYPllB2.344T/C T等位基因频率明显高于NC组(P<0.05).(3)DN组CYP11B2-344T/C多态性CC、CT、TT3种基因型各临床指标均数比较差异无显著性(均P0.05).(4)DN组内微量白蛋白尿期、临床白蛋白尿期和肾功能不全期CC、TT、CT基因型频率和C、T等位基因频率差异均无显著性(均P0.05).(5)CYP11B2-344T/C基因型与DN无相关性(P0.05).(6)DN患者TT基因型血浆醛固酮水平最高.结论:CYP1182-344T/C多态性与2型糖尿病肾病无显著相关性.     

2型对氧磷脂酶基因311 Cys/Ser多态性与糖尿病肾病的相关性研究

目的 探讨2型对氧磷脂酶(PON2)基因311Cys／Ser多态性与2型糖尿病肾病的相关性及其与血脂的关系。方法 采用聚合酶链式反应-长度片段多态性(PCR-RFLP)技术，对78例2型糖尿病患者(其中26例单纯性2型糖尿病，52例糖尿病肾病)和30例健康对照者，PCIN2基因311Cys／Ser多态性进行检测。结果 PON2基因311Cys／Ser多态性的基因型频率和等位基因频率在2型糖尿病合并大量蛋白尿组与对照组间差异有统计学意义，Ser等位基因在2型糖尿病合并大量蛋白尿组明显增高。结论 PON2基因311Cys／Ser遗传多态性与中国甘肃地区2型糖尿病并发肾病的发病具有相关性。     

PC-1 amino acid variant Q121 is associated with a lower glomerular filtration rate in type 2 diabetic patients with abnormal albumin excretion rates

OBJECTIVE: To study the relationships between the PC-1 K121Q variant and diabetic nephropathy (DN) in patients with type 2 diabetes. RESEARCH DESIGN AND METHODS: A total of 125 patients with type 2 diabetes and abnormal albumin excretion rate (AER) (range 20-5416 microg/min) were followed up for 4 years with repeated measurements of glomerular filtration rate (GFR). Genomic DNA was extracted from all patients, and the PC-1 K121Q polymorphism was determined by the PCR AvaII restriction enzyme. A subset of 64 patients underwent a percutaneous kidney biopsy at baseline, and glomerular structure was analyzed by electron microscopic morphometric analysis. At baseline, age (56 +/- 8 vs. 59 +/- 7 years), BMI (28.3 +/- 4.3 vs. 28.6 +/- 3.7 kg/m(2)), known duration of type 2 diabetes (11.1 +/- 7 vs. 11.9 +/- 8 years), and HbA(1c) (8.6 +/- 1.8 vs. 8.4 +/- 1.7%) were similar in K121K (KK, n = 87, 73 men/14 women) and XQ (35 K121Q + 3 Q121Q, n = 38, 27 men/11 women) patients. Baseline GFR was 96 +/- 28 ml. min(-1). 1.73 m(-2) and was related (P = 0.01-0.001) to age, known diabetes duration, and systolic blood pressure. RESULTS: XQ patients had lower GFR (P < 0.05) than KK patients (88 +/- 30 vs. 100 +/- 26 ml. min(-1). 1.73 m(-2)); this difference persisted also after factoring in age and known diabetes duration. The rate of progression of DN was similar in KK and XQ patients: %deltaGFR was 4.1/year (median, range: 22.9-30.6) vs. 4.2/year (9.8-26.7). Morphometric parameters of diabetic glomerulopathy were similar in the two genotype groups. CONCLUSIONS: Among patients with type 2 diabetes with abnormal AER, those carrying the Q PC-1 genotype have more severe DN but not a faster GFR decline than KK patients, thus suggesting faster DN development since diabetes diagnosis in XQ patients.     

The association of PC-1 (ENPP1) K121Q polymorphism with metabolic syndrome in patients with coronary heart disease

BACKGROUND: Metabolic syndrome (MS) is a clinical feature, closely associated with insulin resistance, one of the prime underlying causes of overall cardiovascular morbidity, including coronary heart disease (CHD). Considering the association between PC-1 121Q genotype and insulin resistance phenotype, the aim of the present study was to investigate the contribution of PC-1 K121Q polymorphism to the development of MS and its concomitant disorders in CHD patients. METHODS: A total of 130 Caucasians from Serbia, including 80 CHD patients (aged 59.4+/-8.6 years, of a mean BMI 28.9+/-3.9 kg/m2) and 50 control subjects (aged 48.0+/-6.4 years, of a mean BMI 29.6+/-2.1 kg/m2), were genotyped for PC-1 K121Q using a mutagenic separated PCR assay, in order to determine the prevalence of the PC 121Q variant in individuals suffering from CHD and its association with MS. RESULTS: The frequency of PC-1 121Q allele found in CHD patients was 28.5%, with significantly (P<0.01) higher prevalence in those with MS (40% vs. 10%). Both MS (P<0.01) and its components [central obesity (P<0.01), low HDL-cholesterol (P<0.01) and high triglycerides (P<0.05)] were significantly more prevalent in CHD 121Q carriers compared to CHD patients who exhibited the wild-type genotype. A binary logistic regression model has revealed that PC-1 121Q allele carriers had a 5.5 fold increased odds (95%CI: 1.4-20.9, P=0.01) for the MS compared to wild-type carriers. The PC-1 121Q allele contributed to MS components as well, although these associations did not reach statistical significance. CONCLUSION: The findings of the present study support the hypothesis that the PC-1 (ENPP1) 121Q allele is associated with the genetic susceptibility for MS in patients with CHD. Further studies and more extensive research in this area are needed, not only to confirm this association, but to elucidate it in more details.     

Plasma cell membrane glycoprotein 1 (PC-1): a marker of insulin resistance in obesity, uremia and diabetes mellitus

Insulin resistance is a characteristic feature of obesity and type 2 diabetes mellitus, but it is also present in up to 25% of healthy nonobese individuals. The molecular mechanisms causing insulin resistance are not yet fully understood. Recently, overexpression of several potential inhibitors of the insulin receptor tyrosine-kinase activity, a key step in insulin signaling, has been described in insulin-resistant subjects . PC-1 is expressed in many tissues and inhibits insulin signaling either at the level of the insulin receptor or downstream at a postreceptor site. An elevated PC-1 content in insulin target tissues may play an important role in the development of insulin resistance in obesity and type 2 diabetes mellitus. A polymorphism in PC-1 has been demonstrated to be associated with insulin resistance. This was a DNA polymorphism in exon 4 that causes an amino acid change from lysine to glutamine at codon 121 (K121Q). PC-1 121Q allele might predispose independently of other well established risk factors for early myocardial infarction. Testing for the PC-1 K121Q polymorphism might be valuable in patients with a family history of atherosclerotic vascular disease and myocardial infarction. There is growing evidence that genetic factors play an important role in the development of diabetic nephropathy (DN). Efforts to identify these factors rely primarily on the candidate gene approach; candidate genes for insulin resistance may be considered candidates for DN as well. In a stratified analysis according to duration of diabetes, the risk of early-onset end-stage renal disease (ESRD) for carriers of the Q variant was 2.3 times that for noncarriers. The cellular mechanisms for the insulin resistance of pregnancy and gestational diabetes mellitus (GDM) are unknown. Women with GDM have an increased PC-1 content and excessive phosphorylation of serine/threonine residues in muscle insulin receptors. The postreceptor defects in insulin signaling may contribute to the pathogenesis of GDM and the increased risk for type 2 diabetes later in life. Although widely explored, the true cause of insulin resistance in uremic patients is not entirely elucidated yet. During the last decade it was found that erythropoietin (EPO) therapy, used for correction of anemia in patients with end stage renal failure, ameliorates insulin resistance. An increased lymphocyte PC-1 activity over control was found in hemodialysis patients. A two-month EPO therapy significantly decreased PC-1 activity to the control values, suggesting that an effect on PC-1 expression could be implicated in the amelioration of insulin resistance in uremic patients treated with EPO. Current investigations implicate that therapeutic modification of PC-1 expression would be of great benefit for insulin-resistant type 2 diabetics. Metformin, a biguanide oral antidiabetic agent, was shown to affect insulin resistance by decreasing enzymatic activity of overexpressed PC-1 molecules in obese type 2 diabetics. Thiazolidinedione (TZD) insulin-sensitizing drugs are a class of compounds that improve insulin action in vivo. Treatment of patients with TZDs seems to have a beneficial effect on most, if not all, components of metabolic syndrome. TZDs have also been used in the treatment of nondiabetic human insulin-resistant states, and have demonstrated an improvement in insulin sensitivity. Although much remains to be learned about PPAR gamma receptor and TZD action, the advent of TZD insulin-sensitizing agents has an enormous impact on our understanding of insulin resistance. The great potential of insulin resistance therapy illuminated by the TZDs will continue to catalyze research in this area directed toward the discovery of new insulin-sensitizing agents that work through other mechanisms.     

PC-1基因外显子4多态性与中国人2型糖尿病相关性的系统评价

目的系统评价浆细胞膜糖蛋白l（plasmacellglycoprotrin-1,PC-1）基因第4外显子K121Q多态性与中国人2型糖尿病（type2diabetesmellitus,T2DM）的相关性。方法计算机检索CNKI、VIP、CBM、PubMed、EMbase、qheCochraneLibrary（2012年第3期）和WanFangData,查找国内外关于PC．1基因第4外显子K121Q多态性与T2DM相关性的病例-对照研究,检索时限均从1980年至2012年。由2位评价者根据纳入与排除标准独立筛选文献、提取资料并评价质量后,采用RevMan5．0和Stata12．0软件进行Meta分析,采用Egger’S线性回归法分析发表偏倚。结果最终纳入11个研究,包括T2DM患者1637例,对照1730例。Meta分析结果显示：对于中国人群,基因型K／Q人群的T2DM发病风险高于基因型K／K人群[OR=I．84,95％CI（1．19,2．85）,P=0．006];基因型Q／Q＋K／Q人群的T2DM发病风险高于基因型K／K人群[OR=I．92,95％CI（1．18,3．14）,P=0．009];等位基因Q人群的T2DM发病风险高于等位基因K人群[OR=I．83,95％CI（1．16,2．89）,P=0．01010结论中国人群PC-1基因第4外显子K121Q等位基因Q与T2DM发病有关。受纳入研究数量及质量所限,上述结论尚待进一步研究加以验证。     

Evaluation of the PC-1 K121Q and G2906C variants as independent risk factors for ischaemic stroke

Overexpression of plasma cell membrane glycoprotein-1 (PC-1) inhibits insulin receptor tyrosine kinase activity and thus favours insulin resistance and atherosclerotic vascular disease. Recent findings indicate that the minor variant K121Q in the PC-1 gene confers an increased risk for early myocardial infarction independent of other established risk factors. We hypothesized that genetic variants in PC-1 may also influence the risk for cerebrovascular disease. Aim: Therefore, we assessed the association of the PC-1 K121Q variant in the coding region and a polymorphism (G2906C) in the 3' untranslated region of the PC-1 gene with the risk of stroke. Patients: We analyzed 1014 patients with a history of ischaemic stroke from the Vienna stroke registry and 1001 control individuals without vascular disease. Results, conclusion: Genotype frequencies of both genetic variants were similar in patients and controls in the total study population. By multivariate analysis, no interactions were observed between the PC-1 genotype and established vascular risk factors. However, the PC-1 2906C allele was significantly more frequent in patients who suffered from stroke before the age of 40 years. In these patients the risk for ischaemic stroke was increased four-fold.     

The APC E1317Q and I1307K polymorphisms in non-colorectal cancers.

Mutation of the adenomatous polyposis coli (APC) gene is an important initiating factor in the early stages of the multi-step colorectal cancer (CRC) carcinogenesis. APC E1317Q and I1307K variants have been linked to CRC. The aim of this study was to examine the association of these variants with non-colorectal cancers. Mutation screening was performed using real-time PCR. The APC E1317Q variant was detected in 1.25% individuals undergoing testing. Among 2076 patients that were analyzed for this mutation, 404 had cancer outside of the colon. None of the non-colorectal cancer patients was a carrier of the E1317Q polymorphism. The I1307K variant was found in 32 subjects with non-CRC (7.9%). We conclude herein that the E1317Q gene variant in the APC gene is not found in cancers outside of the colon. The prevalence of the more common I1307K variant is similar to that of CRC.     

郑州地区2型糖尿病肾功能衰竭患者芳香酯酶与基因Q192R多态性的关系

目的 探讨郑州地区汉族人群2型糖尿病慢性肾功能衰竭(DN-CRF)与血清芳香酯酶(ArE／PON1)活性及其192位基因多态性的关系。方法 通过检测2型糖尿病组(DM，121例)、DN-CRF组(123例)、健康对照组(127例)等观察对象的血清ArE／PONl活性及其192位基因多态性、血脂和脂蛋白等，进行分析研究。结果 郑州地区汉族人群中存在有ArE／PON1 192位等位基因Q与R，DN-CRF组Q、R基因频率为0．45和0．55，与DM、对照组比较，差异无统计学意义；两病例组患者血清酶活性均低于对照组，DN-CFR组降低幅度最大；DN-CFR组内RR基因型患者高密度脂蛋白胆固醇(HDL-C)、高密度脂蛋白2胆固醇(HDL2-C)水平低于QQ基因型，总胆固醇(TC)、甘油三酯(TG)和氧化型低密度脂蛋白(oxLDL)高于QQ基因型。结论 DN-CRF组ArE／PONl192位基因多态性与DM、健康对照组间虽差异无统计学意义，但不能排除DM合并DN-CRF与ArE／PON1的192位基因多态性有关；DN-CRF患者血清ArE／PON1活性降低，可能是DM合并DN的危险因素。     

Baseline Hepatitis C Virus (HCV) NS3 Polymorphisms and Their Impact on Treatment Response in Clinical Studies of the HCV NS3 Protease Inhibitor Faldaprevir

A challenge to the treatment of chronic hepatitis C with direct-acting antivirals is the emergence of drug-resistant hepatitis C virus (HCV) variants. HCV with preexisting polymorphisms that are associated with resistance to NS3/4A protease inhibitors have been detected in patients with chronic hepatitis C. We performed a comprehensive pooled analysis from phase 1b and phase 2 clinical studies of the HCV protease inhibitor faldaprevir to assess the population frequency of baseline protease inhibitor resistance-associated NS3 polymorphisms and their impact on response to faldaprevir treatment. A total of 980 baseline NS3 sequences were obtained (543 genotype 1b and 437 genotype 1a sequences). Substitutions associated with faldaprevir resistance (at amino acid positions 155 and 168) were rare (<1% of sequences) and did not compromise treatment response: in a phase 2 study in treatment-naive patients, six patients had faldaprevir resistance-associated polymorphisms at baseline, of whom five completed faldaprevir-based treatment and all five achieved a sustained virologic response 24 weeks after the end of treatment (SVR24). Among 13 clinically relevant amino acid positions associated with HCV protease resistance, the greatest heterogeneity was seen at NS3 codons 132 and 170 in genotype 1b, and the most common baseline substitution in genotype 1a was Q80K (99/437 [23%]). The presence of the Q80K variant did not reduce response rates to faldaprevir-based treatment. Across the three phase 2 studies, there was no significant difference in SVR24 rates between patients with genotype 1a Q80K HCV and those without Q80K HCV, whether treatment experienced (17% compared to 26%; P = 0.47) or treatment naive (62% compared to 66%; P = 0.72).