Matsunaga-Irie Seiko, Maruyama Taro, Yamamoto Yukihiro, Motohashi Yoshiko, Hirose Hiroshi, Shimada Akira, Murata Mitsuru, Saruta Takao
Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan.
Diabetes Care. 2004 Feb;27(2):303-7. doi: 10.2337/diacare.27.2.303.
The development of diabetic nephropathy is considered to be associated with oxidative stress. NADPH oxidase and the receptor for advanced glycation end products (RAGE) have attracted attention as mechanisms of generating oxidative stress. We studied the relation between the genotypes of the NADPH p22phox C242T and RAGE G1704T polymorphisms and the development of diabetic nephropathy in type 2 diabetic patients.
Using a retrospective review of clinical data, we allocated 181 Japanese type 2 diabetic patients to one of two groups: patients without diabetic nephropathy (group N; n = 108) and patients developing diabetic nephropathy (group D; n = 73) for 10 years or more. The p22phox C242T and RAGE G1704T polymorphisms were examined by Taqman PCR methods.
The frequency of the p22phox CC genotype was significantly higher in group D than in group N (90 vs. 79%; P = 0.0427). The frequency of the RAGE GT + TT genotype was significantly higher in group D than in group N (26 vs. 13%; P = 0.0313). The frequency of the combination of p22phox CC and RAGE GT + TT genotypes was significantly higher in group D than in group N (22 vs. 8%; P = 0.0057). In multiple logistic regression analysis, systolic blood pressure, HbA(1c), triglycerides, and the combination of polymorphisms were shown to be independent variables.
These results suggest that assessment of the combination of NADPH p22phox C242T and RAGE G1704T polymorphisms may be useful in identifying the risk for developing diabetic nephropathy in type 2 diabetic patients.
糖尿病肾病的发展被认为与氧化应激有关。作为产生氧化应激的机制,NADPH氧化酶和晚期糖基化终产物受体(RAGE)已引起关注。我们研究了NADPH p22phox C242T和RAGE G1704T基因多态性与2型糖尿病患者糖尿病肾病发展之间的关系。
通过回顾性分析临床数据,我们将181例日本2型糖尿病患者分为两组:无糖尿病肾病患者(N组;n = 108)和发生糖尿病肾病10年或更长时间的患者(D组;n = 73)。采用Taqman PCR方法检测p22phox C242T和RAGE G1704T基因多态性。
D组p22phox CC基因型频率显著高于N组(90%对79%;P = 0.0427)。D组RAGE GT + TT基因型频率显著高于N组(26%对13%;P = 0.0313)。D组p22phox CC和RAGE GT + TT基因型组合频率显著高于N组(22%对8%;P = 0.0057)。在多因素logistic回归分析中,收缩压、糖化血红蛋白、甘油三酯以及基因多态性组合被显示为独立变量。
这些结果表明,评估NADPH p22phox C242T和RAGE G1704T基因多态性的组合可能有助于识别2型糖尿病患者发生糖尿病肾病的风险。