PAI-1基因多态与中国人2型糖尿病肾病的相关性

目的探讨纤溶酶原激活物抑制因子-1(PAI-1)基因多态与上海地区中国人2型糖尿病肾病的相关性。方法选取2型糖尿病(T2DM)患者247例组成T2DM组,其进一步分为糖尿病无肾病组(n=80)和糖尿病肾病组(n=167),后者又分为微量蛋白尿肾病组(n=129)和显著蛋白尿肾病组(n=38);同时设立非糖尿病对照组(n=87)。应用等位基因特异性PCR法(ASP法)检测PAI-1基因启动子区——675 bp处的4G/5G多态,确定各组PAI-1基因的基因型。采用χ2检验对组间各基因型频率及等位基因频率进行比较,并比较组间携带纯合子风险等位基因4G/4G的基因型频率差异。结果T2DM组与非糖尿病对照组相比,4G/4G基因型及4G等位基因频率无统计学差异(P>0.05)。与糖尿病无肾病组相比,糖尿病肾病组4G/4G基因型频率显著增加(P<0.01,OR=2.4,95%C I=1.3～4.4),4G等位基因频率亦显著增加(P<0.05,OR=1.6,95%C I=1.1～2.3)。结论PAI-1基因多态与中国人T2DM无肾病患者进展为糖尿病肾病显著相关;携带PAI-1基因的4G/4G纯合子基因型的糖尿病患者,其进展为糖尿病蛋白尿肾病的风险增加2.4倍。

Correlation of plasminogen activator inhibitor-1 gene polymorphism with type 2 diabetic nephropathy in Chinese

Objective To explore the relationship between 4G/5G polymorphism of plasminogen activator inhibitor-1(PAI-1) gene and type 2 diabetic nephropathy(DN) in Chinese Han. Methods Patients with T2DM(n=247) and non-DM controls(n=87) were selected for the study.Those with T2DM were divided into non-DN group(n=80) and DN group(n=167),and the latter were sub-divided into microalbuminuria DN group(n=129)and predominant proteinuria DN group(n=38).The individual genotypes of 4G/5G polymorphism in PAI-1 gene were determined by allele-specific PCR.Genotypic and allelic frequencies and clinical characteristics were compared among groups by chi square test. Results There was no significant difference in genotypic or allelic frequencies between non-DM control and T2DM groups(P>0.05).Compared with non-DN T2DM group,frequency of genotype 4G/4G and allele 4G in DN T2DM group was significantly elevated(P<0.01,OR=2.4,95%CI=1.3-4.4;P<0.05,OR=1.6,95%CI=1.1-2.3).Conclusion 4G/5G polymorphism of PAI-1 gene is well associated with the susceptibility of type 2 diabetic nephropathy,and the 4G/4G homozygote carrier is increased the risk in the development of DN in Chinese subjects with non-DN T2DM.