MTHFR C677T基因多态性与浙江某地区汉族人群2型糖尿病患者急性脑梗死的相关性

目的探讨亚甲基四氢叶酸还原酶(MTHFR)C677T基因多态性与浙江某地区汉族人群2型糖尿病患者急性脑梗死的相关性。方法选取2017年1月至2018年6月在台州市立医院住院患者、门诊及同期体检中心体检人群共396例,分为急性脑梗死合并2型糖尿病组(CIDM,125例)、单纯2型糖尿病组(DM,120例)和性别、年龄相匹配的健康对照组(CON,151例),收集受试者的一般资料和外周血标本。应用聚合酶链反应及荧光探针法对MTHFR C677T进行基因分型检测并测定不同基因型血浆同型半胱氨酸水平。对CIDM组患者相关影响因素进行Logistic回归分析。结果三组受试者在年龄、性别、尿酸、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、总胆固醇、甘油三酯方面差异无统计学意义(P>0.05),在收缩压、舒张压、空腹血糖、叶酸、同型半胱氨酸方面差异有统计学意义(P<0.05)。三组间基因型和等位基因频率分布差异有统计学意义(χ²=17.297、13.095,P<0.05),TT基因型频率CIDM组,高于DM组和CON组,差异有统计学意义(χ²=9.580、13.500,P<0.05);T等位基因频率在CIDM组,高于DM组和CON组,差异有统计学意义(χ²=7.047、11.844,P<0.05)。CIDM组携带T等位基因的Hcy水平高于同组CC型的Hcy水平,差异具有统计学意义(t=3.937,P<0.05)。Logistic回归分析示MTHFR C677T、同型半胱氨酸、空腹血糖是浙江某地区汉族人群2型糖尿病合并急性脑梗死的独立危险因素OR(95%CI)=1.589(1.127~2.241)、4.815(2.352~9.851)、3.379(1.988~5.746),P<0.01]。结论MTHFR C677T多态性影响Hcy水平,是浙江某地区汉族人群2型糖尿病患者急性脑梗死的危险因素。

Association between the methylenetetrahydrofolate reductase C677T gene polymorphism and cerebral infarction in type 2 diabetes mellitus patients of the Han nationality in a certain area of Zhejiang province

Objective To investigate the association between MTHFR C677 T gene polymorphism and cerebral infarction in type 2 diabetes mellitus patients of the Han nationality in a certain area of Zhejiang province.Methods 396 individuals including inpatients,outpatients and who were from physical examination center in Taizhou municipal hospital from January 2017 to June 2018 were enrolled.Among these participants,125 subjects had acute cerebral infarction combined with type 2 diabetes mellitus were selected as CIDM group,120 subjects had type 2 diabetes mellitus without acute cerebral infarction were selected as DM group,and 151 age and gender matched subjects were selected as the control(CON)group.Basic data of the subjects were collected,and blood samples were taken.Genotyping was completed by the polymerase chain reaction(PCR)and TaqMan probe.Plasma homocysteine(Hcy)was measured in different genotypes.Related influencing factors of type 2 diabetes mellitus combined with acute cerebral infarction were analyzed by logistic regression.Results There was no statistically significant difference in age,gender,uric acid(UA),low-density lipoprotein cholesterol(LDL-C),high-density lipoproteincholesterol(HDL-C),total cholesterol(TC)and triglyceride(TG)among the three groups(P>0.05).However,there were statistically significant differences in systolic blood pressure(SBP),diastolic blood pressure(DBP),fasting blood glucose(FBG),folic acid and Hcy among the three groups(P<0.05).There were statistically significant differences in genotype and allele frequency distribution among the three groups(χ2=17.297,13.095;P<0.05).The frequencies of the TT genotype were statistically higher in CIDM group than those in DM group and CON group,the differences were statistically significant(χ2=9.580,13.500;P<0.05).The frequencies of T allele were higher in CIDM Group than those in DM Group and CON Group,the differences were statistically significant(χ2=7.047,11.844;P<0.05).Individuals with the T allele(CT+TT)had higher Hcy levels than those with the CC genotype in CIDM group,the difference was statistically significant(t=3.937,P<0.05).Logistic regression analysis showed that the MTHFR C677 T,Hcy and FBG were independent risk factors for cerebral infarction in type 2 diabetes mellitus patients of the Han nationality in a certain area of Zhejiang provinceOR(95%CI)=1.589(1.127~2.241),4.815(2.352~9.851),3.379(1.988~5.746);P<0.01].Conclusion Polymorphism of MTHFR C677 T is associated with plasma Hcy level and is the risk factor for cerebral infarction in type 2 diabetes mellitus patients of the Han nationality in a certain area of Zhejiang province.