血管紧张素转化酶基因插入/缺失多态性及β3肾上腺素能受体基因Trp64Arg多态性对胎儿宫内发育及新生儿胰岛素敏感性的影响

目的 探讨血管紧张素转化酶(angiotensin converting enzyme,ACE)基因插入/缺失(insertion/deletion,I/D)多态性及B3-肾上腺素能受体(β3-adrenalgic receptor,β3-AR)基因Trp64Arg多态性对胎儿宫内发育和新牛儿胰岛素敏感性的影响.方法 将入选296例新生儿分为2组,适于胎龄儿组222例,小于胎龄儿组74例,于生后3d哺乳前检测血糖、胰岛素,计算HOMA-IR值评估胰岛素敏感性,应用PCR-RFLP方法分析β3-AR基因Trp64Arg多态性及ACE基因I/D多态性(202例),比较不同基因型组的孕周、出生体重、出生体重百分位及胰岛素敏感性,应用SPSS 10.0软件进行统计学处理.结果 小于胎龄儿组HOMA-IR值(Ln对数转换后)为0.217±0.367,高于适于胎龄儿组0.001±0.378,差异有统计学意义(P

Influence of angiotensin converting enzyme gene insertion/deletion polymorphism and β3-adrenergic receptor gene Trp64Arg polymorphism on fetal growth and neonatal insulin sensitivity

Objective To understand the influence of angiotensin converting enzyme(ACE)gene insertion/deletion(I/D)polymorphism and β3-adrenergic receptor(β3-AR)gene Trp64Arg polymorphism on fetal growth and neonatal insulin sensitivity.Methods Totally 296 newborn infants were selected into our study and divided into 2 groups according to gestational age and birth weight:adequate-for-gestationalage(AGA)group(222 cases)and small-for-gestational-age(SGA)group(74 case).Serum glucose and insulin were examined in the morning of the 3rd day before milk.Insulin sensitivity was evaluated by homeostasis model assessment(HOMA)equation.β3-AR gene Trp64Arg polymorphism and ACE gene I/D polymorphism(202 cases)were analysed using polymerase chain reaction-restricted fragment length polymorphism(PCR-RFLP)technique.Gestational age,birth weight,birth weight percentage,serum glucose,insulin and HOMA-IR were compared among different genotype groups.Statistical analysis was performed with the SPSS 10.0 software.Results No significant difference was found between the sernm glucose level of SGA group(4.03±1.05 mmol/L)and AGA group(4.05±1.14 mmol/L),P=0.008. The serum insulin level(converted into Ln)of SGA group(2.262±0.746)was significantly higher than that of AGA group(1.757±0.805),P<0.001.The HOMA-IR(also convened into Ln)level of SGA group(0.217±0.367)was also significantly higher than that of AGA group(0.001±0.378),P<0.001. In the SGA group β3-AR gene Arg64 allele carriers had higher serum insulin and HOMA-IR level(botll changed to Ln,2.654±0.701,0.371±0.338)compared with noncarriers(2.074±0.698,0.143± O.360),P<0.05.The ACE gene DD genotype carriers had higher serum insulin and HOMA-IR level(both were converted into Ln,2.19 4-0.91,0.5l 4-1.01)compared with II(1.77 ±0.85,0.02 ±0.93) and ID genotype group(1.77 ±0.83,0.05 ±0.91),P<0.05.The ACE gene DD carriers had lower birth weight percentage compared with II and ID genotype group.P<0.05.When both genes'polymorphisms were taken into account,the newborns who had both DD genotype and Arg64 allele had obviously higher serum insulin level(Ln,2.560 ±1.160)than the neonates who had only one of the polymorphisms mentioned above(1.970±0.821,1.992±0.706)and the neonates who had neither of the two potymorphisms(1.683±0.832),P<0.05.The newborns who had both DD genotype and Arg64 allele also had significantly higher HOMA-IR level(Ln,1.042±1.315)than the neonates who had only one of the polymorphisms mentioned above(0.247±0.710,0.230 ±0.890)and the neonates who had neither of the two polymorphisms(-0.053±0.924),P<0.05.Conclusion Newborns SGA had impaired insulin sensitivity.β3-AR gene Trp64Arg polymorphism and ACE gene I/D polymorphism are important factors that may connect IUGR with insulin resistance syndrome in adulthood.