2型糖尿病患者脂联素与视网膜病变的相关性研究

目的研究2型糖尿病（T2DM）患者血浆脂联素（APN）水平及脂联素基因启动子区-11377位点单核苷酸多态性（SNP）与糖尿病视网膜病变（DR）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（PCR-RFLP）技术,对200例T2DM患者无DR（NDR）组82例、非增殖型DR（NP-DR）组72例、增殖型DR（PDR）组46例],检测APN基因启动子SNP-11377C→G多态性,同时检测血浆APN浓度、血脂、血糖、空腹胰岛素,比较各组基因型和等位基因频率,并分析各指标间的相关性。结果①APN水平随视网膜病变程度呈递增趋势NDR、NPDR、PDR各分别为（6.11±2.77）,（7.49±3.84）,（9.83±4.97）mg/L,其中PDR组显著高于NDR和NPDR组（P〈0.01）,NPDR组显著高于NDR组（P〈0.05）;②APN水平与HOMA-IR呈负相关（r=-0.203,P〈0.01）;③APN基因启动子SNP-11377C→G的基因型和等位基因频率分布在NDR组、DR组间差异无统计学意义（P〉0.05）。基因型（CC型、CG型和GG型）的血清APN水平差异无统计学意义（P〉0.05）。结论T2DM患者血APN水平随糖尿病视网膜病变进展而增高。未发现福建地区T2DM患者APN基因启动子区-11377C→G多态性与DR明显相关。

Relationship between adiponectin and retinopathy in patients with type 2 diabetes mellitus

Objective To explore the association of adiponectin level,adiponectin gene-11377 polymorphism and diabetic retinopathy（DR）in patients with type 2 diabetes mellitus.Methods Adiponectin gene SNP-11377C→G was identified in 200 patients with type 2 diabetes mellitus,including 82 patients without retinopathy（NDR,n=82）,72 patients with non-proliferative diabetic retinopathy（NPDR,n=72）and 46 patients with proliferative diabetic retinopathy（PDR,n=46）,by polymerase chain reaction restriction fragment length polymorphism（PCR-RFLP）.Plasma adiponectin,blood lipid,fasting plasma glucose and fasting insulin serum were also measured,and compared with genotype and allele frequencies.Results Plasma adiponectin level showed an increasing tendency in groups of NDR,NPDR and PDR（6.11±2.77）,（7.49±3.84）,（9.83±4.97）mg/L.Plasma adiponectin level was significantly higher in PDR group than in NDR and NPDR groups（P〈0.01）.Plasma adiponectin level was significantly higher in NPDR group than NDR（P〈0.05）.Plasma adiponectin level was negatively correlated with HOMA-IR（r=-0.203,P〈0.01）.The frequencies of adiponectin gene genotype and allele showed no significant difference between NDR and DR groups（P〉0.05）.Plasma adiponectin levels in three genotypes were not different（P〉0.05）.Conclusion Aggravation of diabetic retinopathy accompanied increasing adiponectin level in patients with type 2 diabetes mellitus.There was no significant association of SNP-11377C→G polymorphism in promoter region of adiponectin gene and diabetic retinopathy in patients with type 2 diabetes mellitus of Fujian.