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病因和维生素 D 受体 TaqI rs731236 基因多态性对急性胰腺炎严重程度的影响。

Impact of the etiology and Vitamin D receptor TaqI rs731236 gene polymorphism on the severity of acute pancreatitis.

机构信息

Department of Medical Biochemistry and Molecular Biology, Faculty of Medicine, Assiut University, Assiut, Egypt.

Department of Tropical Medicine and Gastroenterology, Faculty of Medicine, Assiut University, Assiut, Egypt.

出版信息

J Hepatobiliary Pancreat Sci. 2020 Nov;27(11):896-906. doi: 10.1002/jhbp.817. Epub 2020 Sep 7.

Abstract

BACKGROUND/PURPOSE: This work aimed to assess the impact of different etiologies of acute pancreatitis (AP) and vitamin D receptor (VDR) TaqI rs731236 gene polymorphism on the severity of AP.

METHODS

This case-control study included 70 patients with AP and 40 healthy controls. Etiologies of AP were identified by imaging, ANA, cytomegalovirus (CMV) IgM, coxsackie B virus IgM, and IgG4. Genotyping of VDR TaqI rs731236 polymorphism, Laboratory tests and severity scores using Ranson, BISAP, Atlanta and APACHE II scores were determined.

RESULTS

The age in AP patients was 36.03 ± 10.76, and females were 85.7%. The etiologies of AP were as follows: biliary (51.4%), coxsackievirus (22.9%), autoimmune (14.3%), post-ERCP (8.6%) and 2.9% were idiopathic. The TT genotype of VDR polymorphism was significantly more common in AP than control (P = .001) and allele T dominated in AP group (OR = 2; 95% CI: 0.665-5.64). Most cases showed low severity scores with significant differences among etiologies and VDR genotypes. Biliary pancreatitis showed highest percentages of severe AP. However, etiologies and VDR polymorphism were not predictors of severity.

CONCLUSION

Etiology of AP could have impact on the disease severity. VDR gene polymorphism increases the risk of AP. Neither the etiology nor VDR gene polymorphism could predict AP severity.

摘要

背景/目的:本研究旨在评估不同病因的急性胰腺炎(AP)和维生素 D 受体(VDR)TaqI rs731236 基因多态性对 AP 严重程度的影响。

方法

本病例对照研究纳入了 70 例 AP 患者和 40 例健康对照。通过影像学、抗核抗体(ANA)、巨细胞病毒(CMV)IgM、柯萨奇 B 病毒 IgM 和 IgG4 确定 AP 的病因。测定 VDR TaqI rs731236 多态性的基因分型、实验室检查和严重程度评分,采用 Ranson、BISAP、亚特兰大和 APACHE II 评分。

结果

AP 患者的年龄为 36.03±10.76 岁,女性占 85.7%。AP 的病因如下:胆源性(51.4%)、柯萨奇病毒(22.9%)、自身免疫性(14.3%)、内镜逆行胰胆管造影术(ERCP)后(8.6%)和 2.9%为特发性。VDR 多态性的 TT 基因型在 AP 患者中明显多于对照组(P=0.001),并且等位基因 T 在 AP 组中占优势(OR=2;95%CI:0.665-5.64)。大多数病例表现为低严重程度评分,不同病因和 VDR 基因型之间存在显著差异。胆源性胰腺炎表现出最高比例的重症 AP。然而,病因和 VDR 多态性不是严重程度的预测因素。

结论

AP 的病因可能对疾病的严重程度有影响。VDR 基因多态性增加了 AP 的风险。病因和 VDR 基因多态性都不能预测 AP 的严重程度。

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