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中国妊娠期糖尿病患者葡萄糖激酶基因突变的初步筛查。

Preliminary screening of mutations in the glucokinase gene of Chinese patients with gestational diabetes.

机构信息

Key Laboratory of Endocrinology, Ministry of Health, Department of Endocrinology, Peking Union Medical College Hospital, Diabetes Research Center of Chinese Academy of Medical Science & Peking Union Medical College, Beijing, China.

出版信息

J Diabetes Investig. 2018 Jan;9(1):199-203. doi: 10.1111/jdi.12664. Epub 2017 May 24.

Abstract

AIMS/INTRODUCTION: Mutations in the glucokinase gene (GCK) are a pathogenetic cause of maturity-onset diabetes of the young. Studies have found that female patients with GCK maturity-onset diabetes of the young often present with gestational diabetes during pregnancy. Our aim was to preliminarily assess the prevalence of mutations in the glucokinase gene in Chinese women with gestational diabetes.

MATERIALS AND METHODS

Chinese gestational diabetes patients who underwent a 100-g oral glucose tolerance test in Peking Union Medical College Hospital from July 2005 to May 2008 were retrospectively analyzed. Participants were selected for direct sequencing of the GCK gene if they met the following criteria: (i) fasting plasma glucose between 5.5 and 10.0 mmol/L; and (ii) a small increment (<4.6 mmol/L) during a 2-h oral glucose tolerance test.

RESULTS

Of the 501 participants with gestational diabetes, there were 38 participants who met the criteria for GCK analysis. In the 29 participants whose deoxyribonucleic acid samples were available, two mutations in coding regions were detected, c.626 C>T (p.T209M, NP_000153.1) mutation in exon 6 and c.824 G>A (p.R275H, NP_000153.1; rs767565869) mutation in exon 7. According to our results, the minimum prevalence of GCK mutations in Chinese women with gestational diabetes was estimated to be 0.4%, and the minimum prevalence of GCK maturity-onset diabetes of the young in the Chinese population might be one in 2,000.

CONCLUSIONS

Our screening criteria allowed for the identification of glucokinase-deficient patients who were diagnosed with gestational diabetes, and these mutations in the GCK gene were not common in Chinese women with gestational diabetes.

摘要

目的/引言:葡萄糖激酶基因(GCK)突变是青年发病的成年型糖尿病的致病原因。研究发现,携带 GCK 基因的青年发病的成年型糖尿病女性患者在妊娠期间常患有妊娠糖尿病。我们的目的是初步评估 GCK 基因突变在中国妊娠糖尿病女性中的流行率。

材料和方法

回顾性分析 2005 年 7 月至 2008 年 5 月期间在中国医学科学院北京协和医院行 100g 口服葡萄糖耐量试验的中国妊娠糖尿病患者。如果符合以下标准,选择这些患者进行 GCK 基因的直接测序:(i)空腹血糖在 5.5-10.0mmol/L 之间;(ii)2h 口服葡萄糖耐量试验期间血糖升高幅度<4.6mmol/L。

结果

在 501 例妊娠糖尿病患者中,有 38 例符合 GCK 分析标准。在 29 例可获得脱氧核糖核酸样本的参与者中,检测到 2 个编码区突变,外显子 6 中的 c.626 C>T(p.T209M,NP_000153.1)突变和外显子 7 中的 c.824 G>A(p.R275H,NP_000153.1;rs767565869)突变。根据我们的结果,中国妊娠糖尿病女性中 GCK 突变的最低流行率估计为 0.4%,中国人群中 GCK 青年发病的成年型糖尿病的最低流行率可能为每 2000 人中有 1 例。

结论

我们的筛选标准可识别出被诊断为妊娠糖尿病的葡萄糖激酶缺乏患者,而 GCK 基因突变在中国妊娠糖尿病女性中并不常见。

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本文引用的文献

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Standards of medical care in diabetes--2011.《糖尿病医疗护理标准——2011 年》
Diabetes Care. 2011 Jan;34 Suppl 1(Suppl 1):S11-61. doi: 10.2337/dc11-S011.

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