Angiotensin-converting enzyme insertion/deletion polymorphism and polyneuropathy in type 2 diabetes without macroalbuminuria

Angiotensin-converting enzyme (ACE) gene polymorphism is thought to be a potent risk factor for nephropathy and retinopathy in diabetes. We investigated the association between polyneuropathy and gene polymorphisms of both the ACE insertion/deletion (I/D) and angiotensinogen (AGT) M235T genes in 84 type 2 diabetic patients without macroalbuminuria (21 with polyneuropathy and 63 without). ACE genotype distribution did not differ significantly between patients with and without polyneuropathy, but the frequency of the I allele was significantly higher in those with polyneuropathy than in those without. In contrast, neither the genotype distribution nor the allele frequencies of the AGT gene differed between the two groups. In logistic regression analysis using a D-additive model, the D allele had a protective effect on polyneuropathy (odds ratio [OR], 0.34; 95% confidence interval [CI], 0.13-0.88). A D-dominant model hypothesis also gave a significant OR (0.28; 95% CI, 0.09-0.90). ACE I/D polymorphism, but not AGT M235T polymorphism, may affect polyneuropathy development in type 2 diabetes without macroalbuminuria.     

ACE gene insertion/deletion polymorphism associated with 1998 World Health Organization definition of metabolic syndrome in Chinese type 2 diabetic patients

OBJECTIVE: Because ACE insertion/deletion (I/D) polymorphism has been shown to be associated with diabetes, hypertension, coronary artery diseases, and diabetic nephropathy, and because plasma ACE concentration has been found to be associated with plasma triglyceride and total cholesterol levels in patients with type 2 diabetes, the goal of this study was to investigate whether ACE gene I/D polymorphism is associated with metabolic syndrome in Chinese subjects with type 2 diabetes. RESEARCH DESIGN AND METHODS: A total of 711 patients with type 2 diabetes and 750 control subjects were studied. The ACE I/D polymorphism was determined by PCR. The definition and criteria of metabolic syndrome used in this study matched those proposed in the 1998 World Health Organization classification. RESULTS: Of 711 patients with type 2 diabetes, 534 (75.1%) fulfilled the criteria for metabolic syndrome. The prevalence of metabolic syndrome in control subjects with II, ID, and DD genotype was 9.4, 11.5, and 15.4%, respectively, and in patients with type 2 diabetes, it was 68.6, 79.2, and 86.1%, respectively. The ACE I/D polymorphism was significantly associated with the syndrome in patients with type 2 diabetes (P = 0.001). When pooling the control subjects with diabetic patients, the prevalence of metabolic syndrome in the whole study group with II, ID, and DD genotype was 37.9, 44.5, and 51.0%, respectively, and ACE I/D polymorphism was still significantly associated with metabolic syndrome (P = 0.003). Diabetic patients with DD genotype were also found to have a higher prevalence of dyslipidemia (II/ID/DD = 43.1/53.1/65.8%, P < 0.001) and albuminuria (36.0/44.6/50.6%, P = 0.018) and to have higher serum triglyceride levels (II, ID, and DD = 155 +/- 114, 170 +/- 140, and 199 +/- 132 mg/dl, respectively, P < 0.05). Control subjects with DD genotype were also found to have a higher prevalence of albuminuria or more advanced nephropathy (II/ID/DD = 5.7/14.0/15.4%, P = 0.001), whereas the prevalence of dyslipidemia was not found to be statistically different in the control group. When pooling control with diabetic subjects, ACE genotype could still be significantly associated with dyslipidemia (II/ID/DD = 34.7/41.3/52.2%, P < 0.001) and albuminuria or more advanced nephropathy (20.3/28.9/33.1%, P < 0.001). Diabetic patients with metabolic syndrome were found to have higher serum uric acid levels than those without metabolic syndrome (6.4 +/- 1.8 vs. 5.3 +/- 1.4 mg/dl, P < 0.01). CONCLUSIONS: The ACE I/D polymorphism was found to be associated with metabolic syndrome in Chinese patients with type 2 diabetes. This finding may provide genetic evidence to explain the clustering of metabolic syndrome and suggests that the renin-angiotensin system is involved in the pathophysiology of metabolic derangement in patients with type 2 diabetes.     

吉林地区汉族人ACE基因多态性与2型糖尿病合并冠心病的相关性研究

目的 探讨血管紧张素Ⅰ转换酶(ACE)基因插入/缺失(Ⅰ/D)多态性与吉林地区汉族人2型糖尿病患者合并冠心病的关系.方法 对80例2型糖尿病合并冠心病的患者,60例单纯2型糖尿病患者,60名健康人进行分组对照性研究.抽提人外周血中白细胞的基因组DNA,采用聚合酶链反应(PCR)扩增ACE基因第16内含子的一个287bpAlu的插入/缺失(I/D)基因片段,然后进行1.5%的琼脂糖凝胶电泳,并在紫外线灯下观察荧光带并确认每例的基因型.各组间的基因型频率比较应用Hardy-Weinburg遗传平衡定律检验和χ2检验.等位基因频率比较应用χ2检验.结果 各组间ACE基因的基因型频率分布有显著性差异(P＜0.05),等位基因频率分布无明显差异(P＜0.05).结论 ACE基因的I/D多态性与吉林地区汉族人2型糖尿病合并冠心病的发病无显著相关性.     

汉族人群血管紧张素转换酶基因插入/缺失(I/D)的遗传多态性

背景:血管紧张素转换酶是肾素-血管紧张素-醛固酮系统的重要组成部分,血管紧张素转换酶基因第16内含子内存在一个287bp的Alu序列的插入/缺失(I/D)多态性,与心血管疾病、IgA肾病等疾病的发生具有一定的相关性。目的:分析汉族人群血管紧张素转换酶基因插入/缺失(I/D)多态性的分布,并与已知的其他种族人群进行比较。设计:以健康汉族人为观察对象的观察性实验。单位:江苏省临床免疫学重点实验室,苏州大学附属第一医院检验科,江苏大学医学技术学院检验系。对象:受检者为2005-12/2006-01苏州大学附属第一医院门诊健康体检者241名,男152名,女89名,平均年龄(27±8)岁,均为无血缘关系的苏州地区汉族人,经临床及实验室检查确认排除肝、肾、内分泌、心脑血管疾病。方法:应用聚合酶链反应检测了241名汉族健康体检者血管紧张素转换酶基因I/D多态性等位基因的基因型,并采用荧光标记末端终止法对基因型为D/D、I/I的PCR纯化产物进行DNA测序确认。主要观察指标:血管紧张素转换酶基因I/D基因型,等位基因频率以及与其他种族人群的比较。结果:241名受检者全部进入结果分析。①血管紧张素转换酶的基因型表现为缺失纯合子(DD)、插入纯合子(II)以及缺失和插入杂合子(DI),等位基因D较等位基因Ⅰ缺失一段287bp的核苷酸,即Alu序列。②II,ID,DD基因型频率分别为46.1%,41.5%,12.4%;等位基因I,D频率分别为66.8%,33.2%。③日本人与汉族人群血管紧张素转换酶基因型分布相似,均以II型最常见,DD型最少;欧美人群以ID居多,II型较少。汉族人群与日本人及欧美人群血管紧张素转换酶基因型频率的分布具有种族差异性。与其他各民族人群比较,汉族人群等位基因I显著高于上述各民族(χ2=105.55,P<0.01),等位基因D明显较低(χ2=87.54,P<0.01)。结论:血管紧张素转换酶基因多态性具有种族差异性。了解不同种族人群间血管紧张素转换酶基因多态性的遗传特点,是研究血管紧张素转换酶基因I/D多态性与疾病相关性的基础和前提。     

汉族人群血管紧张素转换酶基因插入／缺失（I／D）的遗传多态性

背景：血管紧张素转换酶是肾素-血管紧张素-醛固酮系统的重要组成部分，血管紧张素转换酶基因第16内含子内存在一个287bp的 Alu序列的插入／缺失（I／D）多态性，与心血管疾病、IgA肾病等疾病的发生具有一定的相关性。 目的：分析汉族人群血管紧张素转换酶基因插入／缺失（I／D）多态性的分布，并与已知的其他种族人群进行比较。 设计：以健康汉族人为观察对象的观察性实验。 单位：江苏省临床免疫学重点实验室，苏州大学附属第一医院检验科，江苏大学医学技术学院检验系。 对象：受检者为2005-12／2006-01苏州大学附属第一医院门诊健康体检者241名，男152名，女89名，平均年龄（27&;#177;8）岁，均为无血缘关系的苏州地区汉族人，经临床及实验室检查确认排除肝、肾、内分泌、心脑血管疾病. 方法：应用聚合酶链反应检测了241名汉族健康体检者血管紧张素转换酶基因I／D多态性等位基因的基因型，并采用荧光标记末端终止法对基因型为D／D、I／I的PCR纯化产物进行DNA测序确认。 主要观察指标：血管紧张素转换酶基因I／D基因型，等位基因频率以及与其他种族人群的比较。 结果：241名受检者全部进入结果分析。①血管紧张素转换酶的基因型表现为缺失纯合子（DD）、插入纯合子（Ⅱ）以及缺失和插入杂合子（DI），等位基因D较等位基因I缺失一段287bp的核苷酸，即Alu序列。（2）Ⅱ，ID,DD基因型频率分别为46．1％，41．5％，12．4％；等位基因I，D频率分别为66．8％，33．2％。（3）日本人与汉族人群血管紧张素转换酶基因型分布相似，均以Ⅱ型最常见，DD型最少；欧美人群以ID居多，Ⅱ型较少。汉族人群与日本人及欧美人群血管紧张素转换酶基因型频率的分布具有种族差异性。与其他各民族人群比较，汉族人群等位基因Ⅰ显著高于上述各民族（X^2=105．55，P〈0．01），等位基因D明显较低（X^2=87．54，P〈0．01）. 结论：血管紧张素转换酶基因多态性具有种族差异性。了解不同种族人群间血管紧张素转换酶基因多态性的遗传特点，是研究血管紧张素转换酶基因I／D多态性与疾病相关性的基础和前提。     

Renin-angiotensin system gene polymorphisms, blood pressure, dyslipidemia, and diabetes in Hong Kong Chinese: a significant association of tne ACE insertion/deletion polymorphism with type 2 diabetes

OBJECTIVE: In Chinese populations, hypertension is common and is a major risk factor for cerebrovascular and coronary heart disease, particularly when associated with diabetes. The clustering of these disorders and dyslipidemia and obesity is termed the metabolic syndrome and is increasing in prevalence in the populations of modernizing Asian nations. The renin-angiotensin system (RAS) helps maintain blood pressure and salt homeostasis and may play a role in the pathogenesis of aspects of the metabolic syndrome. We investigated three RAS gene polymorphisms--the ACE insertion/deletion (I/D), angiotensinogen (AGT) M235T, and angiotensin II type 1 receptor (AT1R) A1166C polymorphisms--for a possible role in modulating these disorders in 853 Chinese subjects with varying components of the metabolic syndrome. RESEARCH DESIGN AND METHODS: The three gene polymorphisms of this cross-sectional study were detected using polymerase chain reaction-based protocols. The genotype frequencies were compared between the controls (n = 119) and both overlapping and nonoverlapping groups of patients with type 2 diabetes, hypertension, and dyslipidemia using chi2 test. Differences in levels of the biochemical parameters between the genotypes were determined using analysis of variance. RESULTS: No significant relationship was identified between these polymorphisms and blood pressure in this population. Although the AT1RA1166C polymorphism was not associated with any aspect of the metabolic syndrome examined, there was limited evidence to suggest that the AGT M235T polymorphism may be associated with cholesterol levels. The ACE I allele was significantly more frequent in each group comprising subjects with type 2 diabetes/glucose intolerance (GIT), and the I allele was associated with higher fasting plasma glucose levels. CONCLUSIONS: These findings suggest that these polymorphisms are unlikely to be involved in the pathogenesis of hypertension. The ACE I/D polymorphism was associated with the metabolic syndrome, having a higher frequency of I allele-containing genotypes in those groups, but this appeared to result predominantly from the relationship with type 2 diabetes/GIT in this population of Chinese subjects.     

Influence of insertion/deletion polymorphism in the ACE-I gene on the progression of diabetic glomerulopathy in type 1 diabetic patients with microalbuminuria

OBJECTIVE: To investigate the influence of the insertion/deletion polymorphism of the ACE gene on the progression of early diabetic glomerulopathy in patients with and without antihypertensive treatment (AHT). RESEARCH DESIGN AND METHODS: There were 30 microalbuminuric patients with >5 years of type 1 diabetes who had renal biopsies taken at baseline and after 26-48 months of follow-up. Of the 30 patients, 13 (4 with II genotype and 9 with ID and DD genotypes) were randomized to AHT (enalapril or metoprolol) during the study. The ACE genotype was determined by a polymerase chain reaction. Glomerular structural changes were measured by stereological methods. RESULTS: Of the patients, 8 had the II genotype, 19 had ID genotype, and 3 had DD genotype. During the study, basement membrane thickness, matrix star volume, and the overall diabetic glomerulopathy index were increased in patients with ID and DD genotypes only (P < 0.001, P = 0.01, P < 0.001, respectively). Among those with ID and DD genotypes, progression of basement membrane thickening and diabetic glomerulopathy index were increased in those without AHT, as compared with the antihypertensive treated patients (P < 0.001, P = 0.02, respectively). In multivariate analysis, the ACE genotype had an independent influence on the progression of basement membrane thickening (P = 0.01), when AHT (P < 0.001) and the mean HbAlc during the study (P < 0.001) were also taken into account. ACE genotype tended to be independently associated with the diabetic glomerulopathy index (P = 0.05). CONCLUSIONS: Microalbuminuric type 1 diabetic patients carrying the D-allele have an increased progression of diabetic glomerulopathy. Presence of this allele and no AHT seems to enhance this process. Larger studies are needed to confirm the clinical significance of our findings.     

PAI-1 4G/5G insertion/deletion promoter polymorphism and microvascular complications in type 2 diabetes mellitus

BACKGROUND: Plasminogen activator inhibitor-1 (PAI-1) plays an important role in the regulation of fibrinolysis and extracellular matrix turnover. PAI-1 4G/5G insertion/deletion polymorphism in the PAI-1 promoter region has been shown to modulate PAI-1 plasma levels. We investigated the relationship between this polymorphism and the prevalence of diabetic nephropathy and retinopathy in patients with type 2 diabetes in the Austrian population. PATIENTS AND METHODS: 147 consecutive patients with type 2 diabetes mellitus (96 men, 51 women; median age, 65 years; IQR, 59-71) were analyzed for the PAI-1 4G/5G genotype. RESULTS: The genotype distribution in the individuals tested was as follows: 17% (n = 25) 5G/5G, 54% (n = 80) 4G/5G, and 29% (n = 42) 4G/4G. Patients homozygous for allele 4G had a significantly higher risk of diabetic proliferative retinopathy than patients without signs of diabetic retinopathy or nonproliferative retinopathy (OR, 7.3; 95% CI, 1.4-38.8; P = 0.02). No significant associations were observed between the PAI-1 genotype and the presence of albuminuria. CONCLUSION: According to our results, diabetic proliferative retinopathy might be associated with the prevalence of PAI-1 genotype 4G/4G.     

血管紧张素转换酶缺失等位基因与IgA肾病预后的关系

目的探讨ACE基因插入/缺失多态性与IgA肾病发生发展的关联。方法利用一对侧翼引物及一对序列特异性引物和多聚酶链反应(PCR)技术,对ACE基因多态性及其与IgA肾病的关联进行相关分析。结果肾活检时血清肌酐升高的IgA肾病患者DD基因型频率明显增高(P<0.05);而Ⅱ基因型频率在轻度肾小球病变组明显增高(P<0.05)。结论ACE-DD基因型与肾活检时肾功能减退有关,而Ⅱ基因型与轻度肾小球病变有关。提示ACE-D等位基因可能是IgA肾病预后不良的遗传标志。     

SGLT2抑制剂对2型糖尿病患者心血管结局影响的网状meta分析

目的 2型糖尿病是一种慢性疾病,而心血管事件是2型糖尿病常见的并发症,已有大型研究表明钠-葡萄糖共转运体抑制剂(SGLT2i)对改善2型糖尿病患者心血管结局具有一定作用。本文通过系统评价,间接比较了5种不同的SGLT2i对2型糖尿病并发不良心血管事件的疗效作用。方法 检索PubMed、Web of science、Cochrane Library、中国知网、万方、维普数据库,收集相关文献,检索时限为建库至2022年7月,由两位研究员独立筛选文献,并提取相应数据,以心力衰竭住院和心血管死亡复合结局为主要结局指标,以心力衰竭住院、心血管死亡和全因死亡为次要结局指标,使用Stata 16.0以及network程序包进行网状meta分析。结果 共检索到340篇文献,最终纳入11篇文献,包括62 904例患者,涉及5种干预手段,分别为:恩格列净、索格列净、达格列净、埃格列净和卡格列净。5种不同的SGLT2i在改变2型糖尿病患者的心力衰竭住院和心血管死亡复合结局、心血管死亡、心力衰竭住院和全因死亡方面差异无统计学意义(P>0.05)。与安慰剂相比,5种不同的SGLT2i均可显著改善2型糖尿病患者心力衰竭住院结局;恩格列净和索格列净在改善心力衰竭住院和心血管死亡复合结局方面差异有统计学意义;而在改善心血管死亡或全因死亡结局方面,安慰剂和5种不同的SGLT2i之间的差异均无统计学意义。结论 在改善2型糖尿病患者心力衰竭住院和心血管死亡复合结局和心力衰竭住院结局方面,恩格列净和索格列净有较显著的获益趋势,而针对心血管死亡或全因死亡结局,5种不同的SGLT2i与安慰剂间的差异无统计学意义,具体机制和原因仍需大型研究进行探索和验证。     

ACE gene polymorphism as a prognostic indicator in patients with type 2 diabetes and established renal disease.

OBJECTIVE: To investigate whether the DD genotype is a predictor of mortality and of the decline in renal function in patients with type 2 diabetes and established nephropathy. RESEARCH DESIGN AND METHODS: A total of 56 such patients of Maltese Caucasian descent were recruited, and their ACE genotype was determined. Serum creatinine was estimated approximately every 4 months. The glomerular filtration rate (GFR) was calculated according to the Cockroft-Gault formula, and rate of change was determined by regression analysis. RESULTS: The rate of change in calculated GFR was -7.76 ml.min(-1).year(-1) in those with the DD genotype (n = 31) and -1.17 ml. min(-1). h(-1) in those with the ID or II genotype (n = 25) (P < 0.01). The 3-year mortality was 45.2% in the DD group compared with 20.0% in the ID/II group (P < 0.05). CONCLUSIONS: The DD genotype of the ACE gene polymorphism is associated with a more rapid decline in renal function and higher mortality in type 2 diabetic patients with established nephropathy.     

ACE gene insertion/deletion polymorphism modulates capillary permeability in hypertension

A D/D (deletion/deletion) polymorphism within the ACE (angiotensin 1-converting enzyme) gene increases the risk of microalbuminuria, a predictor of atherosclerotic vascular disease, in essential hypertension. It is unknown, however, whether this genetic profile is accompanied by disturbed macromolecular permeability of systemic capillary endothelium, possibly in the context of generalized endothelial dysfunction. In the present study, the ACE gene polymorphism was determined by PCR in 79 never-treated uncomplicated hypertensive men and 16 normotensive men as controls. Evaluation variables were TERalb (transcapillary escape rate of albumin; the 1-h decline rate of intravenous (125)I-albumin, a measure of integrity of systemic capillary endothelium), albuminuria and forearm vasodilation to intra-arterial acetylcholine, an index of NO (nitric oxide)-mediated vasomotion, in addition to a series of sensitive parameters of albumin permeation (blood pressure, metabolic status and smoking habits). Analyses were done by comparing D/D homozygotes with grouped I/D (insertion/deletion) and I/I (insertion/insertion) subjects. TERalb was higher in D/D hypertensives, who had higher albuminuria, more frequent microalbuminuria and comparable forearm responsiveness to intra-arterial acetylcholine. Fasting glucose and insulin, insulin sensitivity, 24-h blood pressure, smoking habits and metabolic parameters did not differ between the two groups. TERalb and urine albumin values were positively associated in the hypertensive subjects. In conclusion, ACE D/D homozygosis, independently of several confounding factors, associates with higher TERalb in men with essential hypertension. This may reflect noxious genetic influences on systemic vascular permeability, a critical control mechanism for atherogenesis in the absence of grossly impaired NO-mediated arteriolar responsiveness. The parallel behaviour of TERalb and albuminuria suggests some shared genetically mediated determinant of renal and systemic microvascular abnormalities in hypertension.     

中国汉族人ACE基因插入/缺失多态性与糖尿病肾病关联性Meta-分析

目的对中国汉族人血管紧张素l转换酶(ACE)基因内含子16插入(I)/缺失(D)多态性与糖尿病肾病(DN)的关联性进行Meta-分析.方法以DN组和糖尿病非DN对照组基因型分布的OR值为统计量.全面检索到相关文献,剔除不符合要求的文献,应用REVMAN3.1软件对各研究结果进行一致性检验和采用相应的数学模型进行数据合并.结果病例组比对照组的合并OR值及其95%可信区间为NIDDM组12篇文献DD/ID+11和II/ID+DD合并OR值分别为2.17(1.74-2.70)和0.49(0.36-0.66);IDDM组3篇文献DD/ID+II和II/ID+DD合并OR值分别为3.92(2.05-7.47)和0.19(0.09-0.43).P值均小于0.01.结论中国汉族人ACE/ID多态性与DN有关联,DN患者DD基因型多,II基因型少.     

Beneficial effect of atorvastatin on renal function in patients with type 2 diabetes

Two studies investigated the effect of atorvastatin on glycaemic control and renal function in patients with type 2 diabetes. In study 1, 27 outpatients with hypercholesterolaemia (16 statin-na?ve, 11 switched from another statin) took atorvastatin (10 mg once daily) for 3 months. After 3 months, low-density lipoprotein cholesterol (LDL-C) had decreased significantly in both groups, high-density lipoprotein cholesterol (HDL-C) and estimated glomerular filtration rate had increased only in the statin-na?ve group, and glycosylated haemoglobin (HbA(1c)) had not changed significantly in either group. Study 2 was a retrospective investigation of 87 outpatients with hyper cholesterolaemia who had been taking atorvastatin for at least 4 years. Compared with baseline (patients who had taken atorvastatin for at least 1 year), total cholesterol and triglyceride levels did not change over the study period, HDL-C increased significantly at 2 and 3 years, HbA(1c) was significantly decreased at 1, 2 and 3 years and serum creatinine was significantly decreased at 1 year. Atorvastatin lowered LDL-C concentration, did not worsen glycaemic control and might improve renal function in patients with type 2 diabetes.     

ACE基因插入/缺失多态性与228例原发性高血压的相关性研究

目的探讨血管紧张素转化酶（ACE）基因插入/缺失（I/D）多态性与青岛地区原发性高血压（EH）的发生以及高血压分级间的相关性。方法选择青岛地区EH患者228例和119例正常对照,测定两组血压、血脂、血糖等临床及生化指标,并对高血压进行分级。采用聚合酶链反应技术（PCR）,检测ACE基因型。结果 EH组与对照组相比,两组间基因型频率比较差异无统计学意义（P〉0.05）,等位基因频率比较差异有统计学意义（P〈0.05）。进一步以性别进行分层,男性EH组与男性对照组相比,基因型及等位基因分布频率差异均有统计学意义（P〈0.05）;而女性EH组与女性对照组相比,基因型及等位基因分布频率差异均无统计学意义（P〉0.05）。结合趋势检验,EH组中等位基因D与血压的分级呈正相关（P〈0.05）。结论 ACE基因等位基因D与EH的发生相关,尤其与男性EH相关,并与血压的分级相关联。     

中国人脑梗死ACE基因插入/缺失多态性的Meta-分析

目的：对中国人血管紧张素I转换酶（ACE）基因内含子16插入型（I）／缺失型（D）多态性与脑梗死的关联性进行Meta-分析。方法：以脑梗死组和非脑梗死对照组基因型分布的OR值为统计量。全面检索到相关文献,排除发表偏倚的影响,剔除不符合要求的文献,应用REVMAN3．1软件对各研究结果进行一致性检验和采用相应的数学模型进行数据合并。结果：相关文献未发现显著发表偏倚,数据合并结果未考虑原发病的脑梗死和继发于原发性高血压的脑梗死患者DD／（ID＋Ⅱ）OR有显著统计意义,继发于Ⅱ型糖尿病的脑梗死DD／（ID＋Ⅱ）OR无显著性。结论：中国人ACE／ID多态性中DD基因型与非糖尿病性脑梗死有关联,病例组DD基因型增多。     

The influence of adiponectin gene polymorphism on the rosiglitazone response in patients with type 2 diabetes

OBJECTIVE: The aim of this study was to examine the effects of rosiglitazone on adiponectin and plasma glucose levels in relation with common adiponectin gene (ACDC) polymorphisms. RESEARCH DESIGN AND METHODS: A total of 166 patients with type 2 diabetes were treated with rosiglitazone (4 mg/day) for 12 weeks without changing any of their previous medications. In all, single nucleotide polymorphism (SNP)45 and SNP276 of ACDC were examined. RESULTS: Regarding SNP45, there was a smaller reduction in the fasting plasma glucose (FPG) level and the HbA(1c) value in the carriers of the GG genotype than in the carriers of the other genotypes (P = 0.031 and 0.013, respectively). There was a smaller increase in the serum adiponectin concentration for the GG genotype than for the other genotypes (P = 0.003). Regarding SNP276, there was less reduction in the FPG level for the GG genotype than for the other genotypes (P = 0.001). In the haplotype analysis, the reductions in the FPG and HbA(1c) levels were smaller for the GG homozygote haplotype than for the other haplotypes (P = 0.001 and 0.001, respectively). The increase in the plasma adiponectin concentration for the GG homozygote haplotype was smaller than that of the other haplotypes (P = 0.003). CONCLUSIONS: These data suggest that genetic variations in the adiponectin gene can affect the rosiglitazone treatment response of the circulating adiponectin level and blood glucose control in type 2 diabetic patients.     

Association of the insertion/deletion gene polymorphism of the apolipoprotein B signal peptide with myocardial infarction in Tunisian patients

BACKGROUND: Numerous polymorphisms of the apolipoprotein B (APOB) gene have been described. Particularly, the insertion/deletion (Ins/Del) polymorphism located in the coding part of the signal peptide of apoB, associated with modification of lipid concentrations and the risk of coronary artery disease and/or myocardial infarction (MI), has been reported in the general population. Moreover, conflicting results emerge from the literature and suggest that the effect is context-dependent. In the present study, the first investigation of the Ins/Del polymorphism of the APOB gene in Tunisian patients with MI, we examined a possible association between this polymorphism and MI in a subgroup of the Tunisian population. METHODS: A total of 318 Tunisian patients with MI and 368 healthy controls were included in the study. Genomic DNA was extracted from white blood cells, and the Ins/Del polymorphism was determined by electrophoresis in polyacrylamide gels after PCR amplification. A binary logistic regression analysis was performed to test how the association between MI and Ins/Del polymorphism is independent from confounding factors. RESULTS: A significant difference in genotype distribution and allele frequency was observed between patients and controls. Patients with MI had a frequency of 7.2% for the Del/Del genotype, 39.6% for the Ins/Del genotype, and 53.1% for the Ins/Ins genotype. Controls had a frequency of 3.0% for the Del/Del, 32.1% for the Ins/Del and 64.9% for the Ins/Ins genotype (chi2=12.93, p=0.002). The MI patient group showed a significantly higher frequency of the Del allele compared to controls (27.1% vs. 19.1%; chi2=12.50, p=0.0004). In comparison to the Ins/Ins homozygotes, the odds ratio (95% confidence interval) for MI was 1.51 (1.09-2.07) for Ins/Del heterozygotes and 2.95 (1.40-6.22) for Del/Del homozygotes. In multivariate analysis, age (p=0.001), smoking (p<0.001), hypertension (p=0.001), diabetes mellitus (p<0.001), and dyslipidemia (p=0.01) were independent correlates of the presence of MI, whereas the Ins/Del polymorphism (p=0.330) was not an independent predictor of MI. CONCLUSIONS: The present study shows a significant but not independent association between the Ins/Del polymorphism of the APOB gene and MI in the Tunisian population.     

载脂蛋白E基因多态性与2型糖尿病患者发生脑梗死的相关性研究

目的探讨载脂蛋白E(APOE)基因多态性与2型糖尿病患者发生脑梗死的相关性。方法采用病例-对照的研究方法,收集2016年8月至2019年3月中日友好医院内分泌和神经内科245例2型糖尿病无脑梗死患者(CON组)(男/女,128/117例)和270例2型糖尿病发生脑梗死患者(CI组)(男/女,145/125例),年龄范围40~85岁。采用实时荧光定量PCR技术检测APOE基因的多态性。应用t检验和χ^2检验比较两组间差异。结果CI组有高血压病史的患者(84.12%)显著高于CON组(70.42%)(χ^2=15.91,P<0.05);且CI组患者收缩压(142.78±20.52)mmHg明显高于CON组(133.89±18.58)mmHg(t=-5.16,P<0.05)。CI组与CON组比较,APOEε2/ε3及ε3/ε4基因型频率明显增高,而ε3/ε3基因型频率明显减低(χ^2=11.48,P<0.05);APOE的等位基因频率比较显示,CI组ε4的基因频率高于CON组,而ε3的基因频率低于CON组(χ^2=7.00,P<0.05)。Logistic回归分析显示,高血压史(OR=1.95,P<0.05)、收缩压(OR=1.02,P<0.05)、APOEε2/ε3(OR=2.08,P<0.05)与APOE基因ε3/ε4(OR=1.85,P<0.05)为T2DM患者发生脑梗死的独立危险因素。结论APOE基因的多态性可能与2型糖尿病患者发生脑梗死有关。