摘要
目的:观察糖尿病患者与正常人之间以及不同骨量的糖尿病患者之间维生素D受体基因型的分布差异。方法:选自青岛市内分泌糖尿病研究所内分泌科1998-09/2001-01住院糖尿病患者122例为糖尿病组,诊断参照WHO1999年新标准,并且除外重度吸烟、嗜酒者、肾功能损害者及服用影响骨代谢药物者。2型糖尿病组68例,1型糖尿病组54例。以中国骨质疏松症建议诊断标准为依据诊断骨质疏松和骨量减少。糖尿病组骨量正常58例(男/女=33/25),骨量减少30例(男/女=15/15),骨质疏松34例(男/女=17/17)。并以青岛市内分泌糖尿病研究所62名体检健康成年人为对照组,采用聚合酶链反应限制性片段长度多态性技术对其进行维生素D受体,基因(A-paI,TaqI位点)型检测,并计算其基因分布频率。结果:①1型糖尿病组、2型糖尿病组与健康人维生素D受体基因型分布频率的比较1型糖尿病组Tt基因型的分布频率有增高趋势(1型糖尿病组14.8%,2型糖尿病组7.4%,对照组4.8%,P=0.068)。②维生素D受体基因多态性与糖尿病性骨质疏松的相关性:在糖尿病患者群中,aa基因型在骨量减少和骨质疏松患者中分布频率显著高于糖尿病骨量正常者(骨量减少组63.3%,骨质疏松组73.5%,骨量正常组41.3%,P<0.05),Aa基因型分布频率显著低于骨量正常者(骨量减少组26.7%,骨质疏松组26.5%,骨量正常组44.8%,P<0.05),糖尿病骨质疏松患者中未检出AA基因型。结论:在糖尿患者群中,维生素D受体基因分布与健康人差异不显著。糖尿病患者对应于ApaI酶切位点的维生素D受体基因多态与骨质疏松存在相关性,对应于TaqI酶切位点的维生素D受体基因多态与1型糖尿病的发生有相关趋势,对糖尿病骨质疏松的发生有一定的预测价值。
AIM: To observe the distributive differences of vitamin D receptor genotype between diabetic patients and normal people, and among diabetic patients with different bone mass. METHODS: According to the WHO new standards of diagnosis in 1999, 122 diabetic patients (diabetic group) were selected from the Department of Endocrinology, Qingdao Institute of Endocrinology and Diabetes Mellitus between September 1998 and January 2001, and heavy smokers, alcohol user, and those with renal function lesion and those who took drugs that could affect bone metabolism were excluded. There were 68 cases in the type 1 diabetic group and 54 cases in the type 2 diabetic group. Osteoporosis and bone mass reduce were diagnosed with the evidence of the diagnostic criteria suggested by Chinese osteoporosis. In the diabetic group, 58 cases (male/female=33/25) had normal bone mass, 30 cases (male/female=15/15) had bone mass reduce and 34 cases (male/female=17/17) had osteoporosis. Other 62 healthy adult physical examinees in the Qingdao Institute of Endocrinology and Diabetes Mellitus were taken as controls (control group). Vitamin D receptor genotypes (at ApaI and TaqI sites) were detected with the technique of polymerase chain reaction-restriction fragment length polymorphism, and the frequency of gene distribution was calculated. RESULTS: ① Comparison of the frequency of vitamin D receptor genotype distribution among type 1 diabetic group, type 2 diabetic group and healthy people: The distributive frequency of Tt genotype had a increasing tendency in the type 1 diabetic group (type 1 diabetic group: 14.8%, type 2 diabetic group: 7.4%, control group: 4.8%, P=0.068). ② Correlation between vitamin D receptor gene polymorphism and diabetic osteoporosis: In the diabetic patients, the distributive frequency of aa genotype was significantly higher in the bone mass reduce group (63.3%) and osteoporosis group (73.5%) than in the normal bone mass group (41.3%) (P < 0.05). The distributive frequency of Aa genotype was significantly lower in the bone mass reduce group (26.7%) and osteoporosis group (26.5%) than in the normal bone mass group (44.8%) (P < 0.05); AA genotype was not detected in patients with diabetic osteoporosis. CONCLUSION: The gene distribution of vitamin D receptor has insignificant difference between diabetic patients and normal people. The vitamin D receptor gene polymorphism at AapI site is associated with osteoporosis in diabetic patients, and that at TaqI site has association with the occurrence of type 1 diabetes mellitus, and it has certain value in predicting the occurrence of diabetic osteoporosis.
出处
《中国临床康复》
CSCD
北大核心
2005年第23期177-179,共3页
Chinese Journal of Clinical Rehabilitation
