绝经后女性PAI-1 4G/5G基因多态性与代谢综合征的相关性研究

目的 探讨绝经后女性纤溶酶原激活物抑制因子-1（PAI-1）4G/5G基因多态性与代谢综合征（MS）及其主要组分的关系.方法 728例绝经后女性均来自医院健康查体中心,依据改良的2005年国际糖尿病联盟MS诊断标准,分为无任何MS组分的健康对照组（92例）、伴有1～2个MS组分的非MS组（364例）和MS组（272例）.全自动生化分析仪测定血空腹血糖、总胆固醇、甘油三酯、高密度脂蛋白-胆固醇（HDL-C）、低密度脂蛋白-胆固醇（LDL-C）水平,散射比浊法测定纤维蛋白原,等位基因特异性PCR扩增技术检测PAI-1基因型.结果 3组人群中,4G/4G基因型者血清HDL-C水平均显著低于5G/5G基因型者（P＜ 0.05或0.01）;健康对照组4G/4G基因型者收缩压及血清总胆固醇水平显著高于5G/5G基因型者（P＜0.05）;非MS组4G/4G基因型者纤维蛋白原显著高于其他基因型者（P＜0.05）;而MS组4G/4G基因型者空腹血糖、甘油三酯、纤维蛋白原水平显著高于5G/5G基因型者（P＜0.05或0.01）;3组人群间PAI-1基因型的分布频率无显著差异（x2=5.316,P=0.256）;但3组人群间等位基因的分布频率存在显著差异（x2=6.147,P＜ 0.05）,与健康对照组相比,MS组和非MS组4G等位基因分布频率显著升高,而5G等位基因分布频率显著降低（x2=5.690和4.173;P均＜0.05）; MS患者PAI-1不同基因型间肥胖、高血压和低HDL-C血症检出率无显著差异（x2=0.575,4.230,5.202;P均＞0.05）;但高血糖和高甘油三酯血症的检出率存在显著差异（x2=7.078,8.969;P均＜0.05）,其中,4G/4G基因型患者高血糖和高甘油三酯血症检出率显著增高.结论 PAI-1 4G/5G基因多态性与MS及其组分,尤其是高血糖和高甘油三酯血症密切相关,4G等位基因可能为其易感等位基因.

Relationship between PAI-1 4G/5G polymorphism and metabolic syndrome in postmenopausal women

Objective To observe the relationships between plasminogen activator inhibitor-1 （PAI-1） 4G/5G polymorphisms,metabolic syndrome （MS） and its main components in postmenopausal women.Methods 728 postmenopausal women were selected from physical examination center and were divided into the healthy control group without any component of MS （92 cases）,non MS group with 1-2 components of MS （364 cases）and MS group （272 cases）,according to improved MS diagnostic criteria recommended by International Diabetes Federation in 2005.Serum levels of fasting blood glucose,total cholesterol,triglyceride,high density lipoprotein-cholesterol （HDL-C）,low density lipoprotein-cholesterol （LDL-C）were determined by automatic biochemicalanalyzer,fibrinogen was determined by scatteringturbidimetric and genotypes of PAI-1 were detected by allele-specific PCR amplification.Results Serum level of HDL-C was significantly lower in those with 4G/4G genotype than 5G/5G genotype in three groups （P 〈0.05 or 0.01）.In healthy control group,the levels of systolic blood pressure and serum total cholesterol were significantly higher in those with 4G/4G genotype than 5G/5G genotype （all P 〈 0.05）.In non MS group,the level of fibrinogen was significantly higher in those with 4G/4G genotype than that of the other genotypes （P〈0.05）; while in MS group,the levels of fasting blood glucose,triglyceride and fibrinogen were significantly higher （P 〈0.05 or 0.01）.There were no significant differences among three groups in distribution frequency of PAI-1 genotype （x2 =5.316,P=0.256）,but there were significant differences in distribution of alleles frequency （x2 =6.147,P 〈0.05）.4G allele frequency was significantly increased and 5G allele frequency was significantly decreased in MS group and non MS group than those in healthy control group （x2 =5.690,4.173,all P 〈0.05）.There were no significant differences in detection rate of obesity,hypertension and low HDL-C （x2 =0.575,4.230,5.202,all P 〉0.05）,but there were significant differences in detection rate of hyperglycemia and hypertriglyceridemia between different genotypes in MS group （x2=7.078,8.969,all P 〈0.05） and the detection rate of hyperglycemia and hypertriglyceridemia were significantly increased in 4G/4G genotype.Conclusions The 4G/5G gene polymorphism of PAI-1 is closely related to MS and its components,especially related to hyperglycemia and hypertriglyceridemia,and 4G allele gene may be the susceptible allele.