PAI-1启动子区4G/5G多态性和PAI-1抗原含量与2型糖尿病肾病的相关性研究

目的 观察PAI-1启动子区4G/5G多态性与PAI-1抗原含量在不同人群中的差异,探讨糖尿病肾病（ DN）的发病机制及危险因素.方法 检测2型糖尿病（T2DM）患者、DN患者、健康者血浆PA I-1抗原水平和 PAI-1基因多态性、HbA1C、FBG、血脂、UAER水平.结果 （1）T2DM患者血浆PAI-1抗原含量、HbA1C、TG 水平明显升高,以DN患者升高最显著 ,与其他各组比较有统计学意义（P＜0.05）.（2）PAI-1基因启动区4G/5G多态性可影响血浆PAI-1抗原水平,4G纯合子的血浆PAI-1抗原水平显著高于5G纯合子,差异显著（ P＜0.05）.（3）DN患者4G等位基因频率和4G/4G基因型频率显著增高（P＜0.05） .[ HT6H〗结论 （1） PAI-1基因启动区4G/5G多态性可影响血浆PAI-1抗原水平及TG 水平. （2）DN患者血浆PAI-1抗原含量、TG水平明显升高,HbA1c、TG、PAI-1抗原含量与早期DN的发生有关,属DN的独立危险因素.（3） 中国北方汉族人中T2DM PAI -1基因启动子区4G纯合子携带者发生DN的危险性增加.     

中国人群PAI-1基因40／50多态性与2型糖尿病肾病关系的Meta分析

目的评价中国人群纤溶酶原激活物抑制因子-1（PAI-1）基因4G／SG多态性与2型糖尿病肾病（T2DN）的关系。方法全面检索中国人群T2DN与PAI-1基因4G／5G多态性的病例对照研究,用Meta分析方法对PAI-1基因型分布和等位基因频率进行分析和比较,计算比值比（0R值）。结果共纳入9项符合条件的病例对照研究,Meta分析结果显示T2DN组较2型糖尿病非肾病（T2DM）组,4G／4G、4G／5G基因型及4G、5G等位基因合并OR值分别为3．01、0．61、1．95、0．51（P〈0．05）;T2DN组较正常对照（NC）组,4G／4G、4G／5G基因型及4G、5G等位基因合并OR值分别为2．96、0．70、2．34、0．41（P〈0．05）;T2DM组较NC组PAI-1基因4G／5G多态性各基因型及等位基因合并QR值无统计学差异（P〉0．05）。结论中国人群PAI-1基因4G／SG多态性与T2DN关系密切,4G／4G基因型及4G等位基因是T2DM人群及正常人群患T2DN的危险因素,4G／5G基因型及5G等位基因是患T2DN的保护性因素。     

PAI-1基因多态性与2型糖尿病的相关性

目的分析2型糖尿病患者（T2DM）纤溶酶原激活物抑制物（PAI）-1基因型及分布频率,探讨PAI-1基因多态性与T2DM的关系。方法观察组为34例T2DM患者,对照组为39例健康体检正常者,采用等位基因特异性引物PCR扩增技术检测各组人群PAI-1基因多态性,两组人群血浆PAI-1含量检测采用美国USCNLIFE原装人PAI-1 ELISA试剂盒,酶标仪450nm波长下测定吸光度（OD值）,两次平行测定取均值计算样品PAI．1水平。结果观察组与对照组相比PAI-1基因型频率及等位基因频率均有显著性差异（r=24．127,P〈0．001;X^2=7．312,P〈0．05）。观察组4G等位基因频率明显高于对照组,有显著性差异（X^2=6．280,P〈0．05）。观察组血浆PAI-1水平明显高于对照组（t=10．7,P〈0．01）,观察组内比较4G／4G者血浆PAI-1含量明显高于4G／5G和5G／5G者,有显著性差异（F=21．02,P〈0．001）。结论PAI-1基因多态性与T2DM间存在一定的关联性,其中4C等位基因可能是T2DM发病的危险因子。     

PAI-1抗原及其启动子-675位点4G／5G基因多态性与冠心病的相关性研究

目的探讨纤溶酶原激活物抑制物1（PM-1）抗原多态性与冠心病（CHD）的相关性。方法采用PCR技术检测178例健康人（对照组）和293例CHD患者的（CHD组PAI-1基因多态性，用ELISA法测定其PAI-1抗原水平。结果CHD组-675位点与对照组三种基因型分布无统计学差异；与对照组比较，CHD组PAI-1抗原升高，以4G／4G基因型的PAI-1抗原最高，且与4G／SG、5G／SG基因型比较有统计学差异（P均〈0．01），而对照组三基因型比较无统计学差异。结论PAI-1基因多态性与河南汉族人群CHD无明显相关性；PAI-1抗原水平与4G／4G基因型有相关性，是CHD发生原因之一。     

抵抗素基因+299G/A多态性与T2DM并高血压病的相关性

目的研究抵抗素基因＋299G／A多态性与中国北方地区汉族人群2型糖尿病（T2DM）并高血压病的关系。方法采用聚合酶链式反应-限制性片段长度多态性技术检测北方地区汉族人群261例T2DM患者的抵抗素基因内含子2区299G／A突变。结果T2DM组GG、GA、AA基因型及G／A等位基因频率与非T2DM组比较有显著统计学差异（P〈0．01）；T2DM组GG基因型携带者空腹血糖明显高于AA基因型携带者（P〈0．05）。多元线性逐步回归分析显示，抵抗素基因＋299G／A与收缩压、舒张压无明显相关性。结论抵抗素基因＋299G／A多态性与T2DM有关．与高血压病元明显相关性。     

白介素6基因多态性与2型糖尿病相关性的Meta分析

目的探讨白介素6（IL-6）基因572C／G和174G／C多态性与T2DM的相关性。方法采用RevMan5．0软件对纳入文献进行统计分析,使用森林图和漏斗图分析IL6基因多态性与T2DM的相关性。结果IL-6572C／G基因多态性与T2DM相关性研究共纳入T2DM患者3136例,正常对照者6694名。分析结果显示,在亚裔人群中携带突变572G等位基因者发生T2DM的风险是非携带者的1．25倍（OR=1．25,95％CI：1．12-1．40）,差异有统计学意义（Z=4．03,P〈0．05）,而在非亚裔人群中未发现此相关性;IL-6174G／C基因多态性与T2DM相关性研究共纳入T2DM患者6278例,正常对照者9859名,携带突变174C等位基因者发生T2DM的风险是非携带者0．92倍（0R=0．92,95％CI：0．84～1．01）,差异无统计学意义（Z=1．83,P〉O．05）。结论亚裔人群携带突变的572G等位基因是T2DM危险因素之一,未发现IL6基因174G／C多态性与T2DM存在显著相关性。     

脂联素受体1基因多态性与2型糖尿病相关性研究

目的研究西安地区汉族人群中脂联素受体1（AdipoR1）的两个单核苷酸多态性（SNP）位点与2型糖尿病（T2DM）的关系。方法采用突变特异性扩增系统（ARMS）结合测序方法对西安地区100例T2DM患者（T2DM组）及84名正常对照者（NC组）AdipoRl基因的两个SNP位点进行分析。结果（1）AdipoR1基因SNP-106A／G、SNP 5843A／G在DM组与NC组间基因型频率及等位基因频率差异无统计学意义。（2）AdipoR1基因5843G／G型T2DM患者的诊断年龄明显早于A／A型＋A／G型。结论在西安地区的汉族人群中，AdipoR1基因-106A／G、5843A／G的单个核苷酸多态性可能与T2DM的发病无关。携带5843G／G基因型的T2DM患者发病年龄较早。     

单核细胞趋化蛋白1基因A2518G多态性与2型糖尿病肾病的关系

目的 探讨单核细胞趋化蛋白（MCP-1）基因调节区A2518G多态性与湖南汉族人2型糖尿病（T2DM）合并肾病之间的关系。方法 运用聚合酶链反应限制性片段长度多态性技术（PCR-RFLP），结合DNA测序技术，检测了单纯糖尿病（DM）组86例，糖尿病肾病（DN）组94例；正常对照（NC）102例，282例湖南汉族人的MCP-1基因调节区A2518G多态性。结果 DN组MCP-1G／G基因型频率和G等位基因频率高于DM组、NC组，但差异无统计学意义（P〉0．05）。结论 （1）糖代谢紊乱和脂代谢紊乱是DN发生发展的危险因素；（2）MCP-1A2518G多态性与DN发病无相关性。     

CTLA-4基因外显子1A/G49多态性与1型糖尿病的相关性研究

目的 探讨细胞毒性T淋巴细胞相关抗原4（CTLA－4）基因外显子1的49位点A／G多态性与中国汉族人1型糖尿病（DM）的关系。方法 采用多聚酶链式反应限制性片段长度多态性（PCR－RFLP）技术对33例典型1型DM患者、57例成人晚发自身免疫性糖尿病患者（LADA)和84例健康对照者分析CTLA－4基因外显子1的49位点基因型。结果 1型DM患者的CTLA－4／G^49等位基因频率显著高于对照组（P=0.0005)，而典型1型DM和LADA两组间无显著性差异（P＝0.097)；ICA和GADAb阳性率与G^49无明显相关性（分别为P＝0.065,P=0.066)。结论 CTLA－4基因外显子1多态性与中国汉族人1型DM有关，G^49等位基因是1型DM的独立危险因素之一。     

UCP1基因-3826A>G位点多态性与云南大理地区2型糖尿病患病率相关性的研究

目的 探讨解偶联蛋白1(UCP1)基因-3826 A>G位点多态性与云南大理地区T2DM患病率的相关性。方法 选取2021年1～12月于大理大学第一附属医院内分泌科收治的204例T2DM患者（T2DM组），同期选取174名体检健康者为正常对照（NC）组，收集两组一般资料和生化指标，采用竞争性等位基因特异性PCR(KASP)对UCP1基因-3826 A>G位点进行基因分型并统计分析。结果 T2DM、NC组UCP1基因-3826 A>G位点基因型均符合Hardy-Weinberg遗传平衡（P>0.05）。T2DM组AG、GG基因型频率和G等位基因频率高于NC组。AG、GG基因型和G等位基因可增加T2DM风险1.638、2.109和1.386倍。T2DM患者AG和GG基因型BMI高于AA基因型（P<0.05）。结论 UCP1基因-3826 A>G位点多态性与云南大理地区T2DM相关，且该基因位点突变增加T2DM风险。     

Reactive protein,plasminogen activator inhibitor type-1 （PAI-1） levels,PAI-1 promoter 4G/5G polymorphism and acute myocardial infarction

Objective To investigate the relationship between CRP, plasminogen activator inhibitor type 1 （PAI-1） levels, PAI-1 gene promoter 4G/5G polymorphism and the type of acute myocardial infarction （ST elevation myocardial infarction, STEMI vs the non-ST elevation Myocardial infarction, NSTEMI）. Methods One hundred seventy-six consecutive patients with AMI were included for the study, of whom 60 had STEMI and 56 had NSTEMI, and 60 adults without cardiovascular and cerebrovascular disease were selected as controls. Blood samples were obtained from patients within 6 h of AMI and the plasma PAI-1, CRP, and the gene polymorphism were measured. Results Plasma levels of PAI- 1 and CRP were higher in AMI groups, compared those in the control group, and plasma levels of PAI-1 were significantly higher in patients with STEMI compared to those with NSTEMI （80.12ng/ml VS.73.01ng/ml, P 〈0.01）, while CRP levels were not significantly different between patient with STEMI and NSTEMI （3.87 ± 0.79 mg/ml VS.4.01 ±0.69mg/ml, P〉0.05）. PAI-1 levels presented a significant correlation with CRP levels in the NSTEMI subjects. However, PAI-1 and CRP levels could explain the lack of a significant relationship between them in control and STEMI subjects.The frequencies of 4G/4G genotype in the AMI group were higher than those in the control group and higher in patient with STEMI than in patient with NSTEMI. Plasma levels of PAI-1 in subjects with 4G/4G genotype were significantly increased as compared to those in subjects with 4G/5G and 5G/5G genotype. Conclusions Plasma PAI-1 levels were associated with different myocardial infarction type, and PAI-1 promoter 4G/5G polymorphisms and CRP may be related to plasma PAI-1 levels     

Diabetic retinopathy, PAI-1 4G/5G and −844G/A polymorphisms, and changes in circulating PAI-1 levels in Tunisian type 2 diabetes patients

AimThe association of altered plasminogen activator inhibitor (PAI)-1 levels and PAI-1 polymorphisms (4G/5G and −844G/A) with diabetic retinopathy (DR) was investigated in 856 type 2 diabetes (T2D) patients, of whom 383 presented with (DR group), and 473 presented without (DWR group), retinopathy.MethodsPAI-1 4G/5G and −844G/A genotyping were done by PCR-RFLP, and PAI-1 levels were measured by ELISA testing.ResultsThe genotype distribution of 4G/5G and −844G/A polymorphisms did not deviate from the Hardy-Weinberg equilibrium model among healthy subjects. Higher frequencies of the 4G/4G genotype, and lower frequencies of the −844A allele, −844G/A and −844A/A genotypes, were seen in DR patients, conferring disease susceptibility and protection, respectively. While PAI-1 levels were significantly elevated in the 4G/4G compared with other PAI-1 genotypes, significant differences in PAI-1 levels between DR and DWR patients were seen in the 4G/−844A, 4G/−844G and 5G/−844A haplotype carriers among DR patients. However, comparable distributions of 4G/5G and −844G/A alleles, genotypes and haplotypes, and similar PAI-1 levels, were seen in the proliferative retinopathy (PR) and non-proliferative retinopathy (NPR) patients, indicating that neither PAI-1 variants nor changes in PAI-1 levels were linked to DR severity. Multivariate analyses identified 4G/−844A and 4G/−844G haplotypes as negatively and positively associated, respectively, with DR, but not with DR severity (PR vs NPR) after adjusting for a number of covariates.ConclusionThe present study identifies changes in PAI-1 levels and genetic variations at the PAI-1 locus as risk factors for DR, but not DR severity, that may serve as useful markers of increased DR susceptibility.     

The influence of metabolic syndrome components on plasma PAI-1 concentrations is modified by the PAI-1 4G/5G genotype and ethnicity

Coronary artery disease (CAD) is less common in African than Indian or White subjects and elevated plasminogen activator inhibitor (PAI)-1 levels may be a risk factor for CAD. Therefore, PAI-1 levels were measured in the three populations and related to the -675 PAI-1 4G/5G promoter genotype. PAI-1 levels and anthropometric variables were measured in 310 Indian, 269 White and 107 African subjects. The PAI-1 4G allele frequency was lower in the African (0.13) than Indian (0.54) or White (0.58) populations and explained the lower PAI-1 levels in African (41.5+/-25.1 versus 68.0+/-33.3 and 70.5+/-35.7 ng/ml, respectively; p<0.0001) subjects. Except for White subjects, PAI-1 levels were higher in those with metabolic syndrome or type 2 diabetes. PAI-1 genotype did not associate with either disorder. Metabolic syndrome-related factors had little influence on PAI-1 levels in White subjects but in African and Indians subjects these variables had a major influence on PAI-1 levels in those with the 5G/5G genotype but not in subjects with the 4G/4G genotype. Ethnic differences in PAI-1 levels are largely due to differences in the frequency of the 4G and 5G alleles at the -675 locus. In Indian and African, but not White populations, the ability of metabolic syndrome-related factors to influence PAI-1 levels is modulated by the -675 genotype.     

The 4G/4G polymorphism of the hypofibrinolytic plasminogen activator inhibitor type 1 gene: an independent risk factor for serious pregnancy complications

The specific aim of the current study of 133 women with at least 1 pregnancy and measures of hypofibrinolytic and thrombophilic gene mutations was to determine retrospectively whether the mutations were associated with adverse pregnancy outcomes including prematurity, miscarriage, stillbirth, intrauterine growth retardation (IUGR), eclampsia, and abruptio placentae. Four gene mutations (factor V Leiden, methylenetetrahydrofolate reductase [MTHFR], prothrombin, and 4G/5G polymorphism of the plasminogen activator inhibitor type 1 [PAI-1] gene) were assessed by polymerase chain reaction (PCR). One hundred twenty-two women were genotyped for all 4 genes and divided into gene mutation (n = 68) and non-gene (n = 54) groups. The gene mutation group included those with at least 1 thrombophilic mutation (heterozygous for factor V Leiden, heterozygous for prothrombin, and homozygous for MTHFR), or hypofibrinolysis with homozygosity for the 4G polymorphism of the PAI-1 gene. The non-gene mutation group included those with no mutation for all 4 genes (wild-type normal) or who were wild-type normal for the prothrombin and factor V Leiden mutations and heterozygous for MTHFR and/or 4G/5G for the PAI-1 gene, neither heterozygosity associated with coagulation abnormalities. The 68 women with gene mutations, versus 54 in the non-gene mutation group, has more prematurity (10% v 4%, chi2 = 5.4, P = .021), more IUGR (3% v 0%, P = .035), and more total complications of pregnancy (37% v 21%, chi2 = 11.6, P = .001). The number of pregnancies (P = .0001) and 4G/4G polymorphism of the PAI-1 gene (P = .029) were positively associated with complications of pregnancy by stepwise logistic regression when the age, number of pregnancies, and all 4 gene mutations were the explanatory variables. Heritable hypofibrinolysis, mediated by 4G/4G homozygosity for the PAI-1 gene, is an independent significant, potentially reversible risk factor for pregnancy complications, probably acting through thrombotic induction of placental insufficiency.     

The 4G5G polymorphism in the gene for PAI-1 and the circadian oscillation of plasma PAI-1

Plasminogen activator inhibitor type I (PAI-1) antigen concentrations follow a circadian oscillation peaking in the morning. Some individuals show no apparent circadian rhythm, while others show up to a 10-fold variation in PAI-1 over 24 hours. Results from experimental studies suggest that a polymorphism in the promoter of the gene for PAI-1 (4G5G) directly influences the circadian expression of the PAI-1 gene. We studied whether the diurnal variation of PAI-1 antigen differs for the genotypes of the 4G5G polymorphism. A population-based, cross-sectional study was performed among 263 subjects selected from the Rotterdam Study, a population-based cohort of 7983 men and women aged 55 years and older. The 4G allele was associated with a more pronounced circadian expression of PAI-1 antigen. Morning PAI-1 antigen concentrations were 79 ng/mL (95% confidence interval [CI], 68-92) in subjects homozygous for 4G, 62 ng/mL (95% CI, 54-72) in heterozygous subjects, and 59 ng/mL (95% CI, 49-71) in subjects homozygous for 5G. While respective PAI-1 antigen concentrations in the afternoon were 40 ng/mL (95% CI, 33-49), 41 ng/mL (95% CI, 37-47), and 40 ng/mL (95% CI, 49-71). These findings suggest that the morning increase in PAI-1 antigen concentration is more pronounced among subjects homozygous for the 4G allele compared with the morning increase among the other genotypes. Additionally, these findings show that homozygosity for the 4G allele is associated with increased PAI-1 levels during the morning only.