2型糖尿病患者IL-18基因启动子区-607C/A和-137G/C位点多态性与颈动脉粥样硬化的相关性研究

目的　探讨2型糖尿病(type 2 diabetes mellitus, T2DM)患者IL-18基因启动子区-607C/A和-137G/C位点多态性与颈动脉粥样硬化(carotid atherosclerosis, CAS)的相关性研究。方法　收集2018年1月~2019年12月宝鸡市中心医院收治的375例T2DM患者为研究对象并记为T2DM组，另选择同期该院体检健康的200例志愿者作为对照组，T2DM组患者再根据颈部血管超声结果分为颈动脉内-中膜厚度(carotid intima-media thickness, CIMT)正常组(n=122)和CIMT增厚组(n=253)。采用聚合酶链式反应(polymerase chain reaction, PCR)法检测IL-18基因启动子区-607C/A和-137G/C位点基因型。分别比较各组两位点基因型和等位基因型的分布频率。采用Logistic回归分析法分析T2DM患者CIMT增厚的独立危险因素。结果　对照组和T2DM组的BMI，CIMT和高血压差异具有统计学意义(t=5.270，Z=16.038，χ2=6.261，P＜0.05)，两组吸烟和血脂异常的差异无统计学意义 (χ2=0.800，1.991，均P＞0.05)。CIMT正常组和CIMT增厚组在吸烟、CIMT，糖尿病病程方面的差异具有统计学意义 (χ2=5.302，Z=15.694，12.057，均P＜0.05)，两组BMI，高血压和血脂异常的差异无统计学意义 (χ2=0.567，0.741，3.133，均P＞0.05)。对照组和T2DM组IL-18基因启动子区-607C/A和-137G/C位点基因型和等位基因型分布频率的差异无统计学意义(χ2=1.654，4.939，1.742，2.812，均P＞0.05)。CIMT正常组和CIMT增厚组IL-18基因启动子区-607C/A和-137G/C位点基因型和等位基因型分布频率的差异均具有统计学意义(χ2=11.410，11.957，均P＜0.05)，两组-137G/C位点基因型和等位基因型分布频率的差异均无统计学意义(χ2=3.696，2.931，均P＞0.05)。采用Logistic回归分析法结果显示糖尿病病程和-607C/A(CC vs CA+AA)基因型是T2DM患者CIMT增厚的独立危险因素。结论　T2DM患者中IL-18基因启动子区-607C/A位点多态性与CAS密切相关。

Correlation between-607C/A and-137G/C Polymorphisms in the IL-18 Promoter Region and Carotid Atherosclerosis in Type 2 Diabetes Mellitus

Objective To investigate the The correlation between-607C/A and-137G/C polymorphisms in the IL-18 promoter region and carotid atherosclerosis(CAS)in type 2 diabetes mellitus(T2DM).Methods The 375 patients with T2DM admitted by Baoji Central Hospital from January 2018 to December 2019 were collected and recorded as the T2DM group.In addition,200 volunteers who were healthy during the same period in the hospital were selected as the control group.The patients of the T2DM group were then divided by the carotid intima-media thickness(CIMT normal group)(n=122)and CIMT thickened group(n=253)based on the ultrasonic results of the neck vessels.The genotypes of-607C/A and-137G/C promoters were detected by polymerase chain reaction(PCR).The distribution frequencies of genotypes and alleles at the two loci were compared respectively.Logistic regression analysis was used to analyze the independent risk factors of CIMT thickening in T2DM patients.Results The differences in BMI,CIMT and hypertension between the control group and the T2DM group were statistically significant(t=5.270,Z=16.038,χ²=6.261,all P<0.05),while the differences in smoking and dyslipidemia between the two groups were not statistically significant(χ²=0.800,1.991,all P>0.05).The differences in smoking,CIMT and diabetes course between the CIMT normal group and the CIMT thickened group were statistically significant(χ²=5.302,Z=15.694,12.057,all P<0.05),while the differences in BMI,hypertension and dyslipidemia between the two groups were not statistically significant(χ²=0.567,0.741,3.133,all P>0.05).There was no significant difference in the distribution frequencies of-607C/A and-137G/C promoters between the control group and the T2DM group(χ²=1.654,4.939,1.742,2.812,all P>0.05).There were statistically significant differences in the distribution frequencies of-607C/A and-137G/C polymorphisms and allelic genotypes between the CIMT normal group and the CIMT thickened group(χ²=11.410,11.957,all P<0.05),while there were no statistically significant differences in the distribution frequencies of-137G/C genotypes and allelic genotypes between the two groups(χ²=3.696,2.931,all P>0.05).The results of Logistic regression analysis showed that diabetes course and genotype-607C/A(CC vs CA+AA)were independent risk factors for CIMT thickening in T2DM patients.Conclusion The IL-18 promoter region-607C/A polymorphism is closely related to CAS in T2DM patients.