■我们旨在确定2型糖尿病患者中ACE插入/缺失基因多态性的分布及其与肾病生物标志物和代谢指标的关联。
■数据收集了在Mbarara地区转诊医院的糖尿病诊所接受医疗保健的237名成人2型糖尿病患者。使用常规PCR技术扩增外周血基因组DNA,并分析ACE纯合形式的插入(II),缺失(DD)和杂合插入缺失(ID)基因型以及它们各自的等位基因计数。使用系统兼容的试剂在BeckmancoulterAU480化学分析仪上分析肾病的生物标志物。
■大多数参与者是老年人(中位数=57,IQR=49-64)和女性171(72.2%)。他们中的大多数具有缺失等位基因198(83.5%)和DD基因型116(48.9%)。在多变量逻辑回归中,肾病的生物标志物是微量白蛋白尿,血清肌酐,尿素,eGFR和电解质与ACEI/D等位基因或基因型无关(p>0.05)。另一方面,选定的代谢指标呈正相关。插入等位基因与糖化血红蛋白增加(OR=1.082,p=0.019)和血清葡萄糖水平降低(OR=0.891,p=0.001)相关。等位基因缺失与糖化血红蛋白降低(OR=0.924,p=0.047)和血清葡萄糖水平升高(OR=1.208,p=0.001)相关。ACEII基因型与血清葡萄糖水平降低相关(OR=0.873,p=0.029)。ACEDD基因型与糖化血红蛋白降低(OR=0.917,p=0.010)和血糖升高(OR=1.132,p=0.001)相关。ACEID基因型与糖化血红蛋白升高相关(OR=1.077,p=0.022),甘油三酯水平(OR=1.316,p=0.031)和降低血清葡萄糖水平(OR=0.933,p=0.038)。
■ACEI/D等位基因和基因型的存在或不存在会影响血清葡萄糖的最终升高或降低,糖化血红蛋白和甘油三酯水平。尽管肾病的生物标志物与ACEI/D等位基因或基因型之间没有显著关联,上述涉及的代谢指标应纳入2型糖尿病患者的医疗指南.
UNASSIGNED: We aimed at determining the distribution of the ACE insertion/
deletion gene polymorphisms among type 2 diabetic patients and their association with the nephropathy biomarkers and the metabolic indicators.
UNASSIGNED: Data were collected from 237 adult type 2 diabetes mellitus patients receiving healthcare at the diabetic clinic of Mbarara Regional Referral Hospital. Peripheral blood genomic DNA was amplified using a conventional PCR technique and analyzed for the ACE homozygous forms of the insertion (II),
deletion (DD) and heterozygous insertion
deletion (ID) genotypes as well as their respective allele counts. Biomarkers of nephropathy were analyzed on a Beckman coulter AU480 chemistry analyzer using system compatible reagents.
UNASSIGNED: Majority of the participants were older persons (Median = 57, IQR = 49-64) and female 171 (72.2%). Most of them had the
Deletion allele 198 (83.5%) and DD genotype 116 (48.9%). At multivariate logistic regression, the nephropathy biomarkers that is microalbuminuria, serum creatinine, urea, eGFR and electrolytes had no association with the ACE I/D alleles or genotypes (p > 0.05). On the other hand, selected metabolic indicators had a positive relationship. The insertion allele was associated with increasing glycated hemoglobin (OR = 1.082, p = 0.019) and decreasing serum glucose levels (OR = 0.891, p = 0.001).
Deletion allele was associated with decreasing glycated hemoglobin (OR = 0.924, p = 0.047) and increasing serum glucose levels (OR = 1.208, p = 0.001). ACE II genotype was associated with decreasing serum glucose levels (OR = 0.873, p = 0.029). ACE DD genotype was associated with decreasing glycated hemoglobin (OR = 0.917, p = 0.010) and increasing serum glucose levels (OR = 1.132, p = 0.001). ACE ID genotype was associated with increasing glycated hemoglobin (OR = 1.077, p = 0.022), triglyceride levels (OR = 1.316, p = 0.031) and decreasing serum glucose levels (OR = 0.933, p = 0.038).
UNASSIGNED: The presence or absence of the ACE I/D alleles and genotypes affects the ultimate increase or decrease in the serum glucose, glycated hemoglobin and triglyceride levels. Although there was no significant association between the biomarkers of nephropathy and the ACE I/D alleles or genotypes, the above implicated metabolic indicators should be included in healthcare guidelines used when attending to type 2 diabetic patients.