环氧化酶2基因-765G／C多态性与昆明地区汉族2型糖尿病患者糖尿病肾病发生、发展的关系

目的 探讨环氧化酶2基因启动子区-765G/C多态性与昆明地区汉族2型糖尿病患者糖尿病肾病发生、发展的相关性.方法 选取2008年1月至12月昆明医学院第一附属医院糖尿病科收治住院的2型糖尿病患者252例,根据24 h尿白蛋白排泄率或随机尿白蛋白/肌酐比值分至无糖尿病肾病组（n=100）、隐性糖尿病肾病组（n=78）、显性糖尿病肾病组（n=74）.运用聚合酶链反应-限制性片段长度多态性方法检测环氧化酶2基因启动子区-765G/C多态性.检测血糖、血脂和其他生化指标.运用χ^2检验比较各组基因型频率和等位基因频率,运用方差分析比较各组相关临床及生化指标,采用logistic回归分析评价影响糖尿病肾病发生、发展的危险因素.结果 两糖尿病肾病组-765GG基因型频率与无糖尿病肾病组存在明显差异（0.901 vs 0.810;χ^2=4.309,P＜0.05）.糖尿病肾病患者中,-765GG基因型携带者空腹血糖、餐后2 h血糖与非携带者存在明显差异[分别为（7.9±4.0）vs（5.9±1.7）mmol/L,（12±5）vs（9±4）mmol/L;t值分别为0.001、0.020,均P＜0.05＝.logistic回归分析提示,-765GG基因型是糖尿病肾病发生的独立危险因素之一[比值比（OR）=3.25,95%可信区间（CI）为1.336～7.901].结论 在昆明地区汉族2型糖尿病患者中,环氧化酶2基因启动子区-765GG基因型与糖尿病肾病的发生、发展有关.

Association of cyclooxygenase-2 gene -765G/C polymorphism with diabetic nephropathy

Objective To determine the possible effect of cyclooxygenase-2 (COX-2) -765G/C polymorphism on the risk of diabetic nephropathy (DN) in patients with type 2 diabetes mellitus (T2DM) in Kunming. Methods A total of 252 T2DM patients from the First Affiliated Hospital of Kunming Medical University between January and December 2008 were assigned to the free-DN group (n=100), microalbuminuria DN group (n=78) and macroalbuminuria DN group (n=74) according to 24-hour urinary albumin excretion ratio(24-h UAER) or spot urinary albumin/creatinine (UACR) ratio. The polymorphism of COX-2 gene -765G/C was detected by PCR-RFLP. The genotypes and allele frequency distributions were compared by using χ2 test. The related characteristics of investigated objects were compared by analysis of variance. Logistic regression analysis was performed to calculate correlated markers of DN risk. Results In T2DM patients, -765GG genotype was significantly different between microalbuminuria DN﹢macroalbuminuria DN group and free-DN group (0.901 vs 0.810; χ2=4.309,P<0.05). In DN patients, the levels of fasting plasma glucose (FPG) and 2-hour plasma glucose (2-h PG) of those with -765GG genotype were higher than those without ((7.9±4.0) vs (5.9±1.7) mmol/L, (12±5) vs (9±4) mmol/L, respectively; t values were 0.001 and 0.020, both P<0.05). Logistic regression analysis indicated that -765GG genotype (odds ratio (OR)=3.25; 95%confidence interval (CI): 1.336 to 7.901) was risk factor of DN. Conclusion The COX-2 gene promoter -765GG may be associated with DN in Kunming Han individuals with T2DM.