葡萄糖-6-磷酸脱氢酶（G6PD）及其他生活方式因素与疟疾的保护关系评估：古吉拉特邦一所教学医学院校医务人员的病例对照研究
Assessment of protective relationship of G6PD and other lifestyle factors with Malaria: A case-control study of medical professionals from a teaching medical institute, Gujarat.
作者信息
Pandit Niraj, Kalaria Tejaskumar, Lakhani Jitendra D, Jasani Jasmin
机构信息
Prof and Head, Department of Community Medicine, SBKS Medical Institute and Research Centre and Dhiraj Hospital, Sumandeep Deemed University, Piparia, (Dist :Vadodara) Gujarat, India.
Ex. Assistant Professor in Biochemistry, SBKS Medical Institute and Research Centre and Dhiraj Hospital, Sumandeep Deemed University, Piparia, (Dist :Vadodara) Gujarat, India.
出版信息
J Family Med Prim Care. 2020 Nov 30;9(11):5638-5645. doi: 10.4103/jfmpc.jfmpc_947_20. eCollection 2020 Nov.
BACKGROUND
There remains equivocal evidence in terms of glucose-6-phosphate dehydrogenase (G6PD) and malaria occurrence. A case-control study was performed to assess protective relationship of G6PD and other lifestyle factors with malaria.
METHODS
One-hundred twenty six medical professionals were randomly selected from a tertiary care clinical institute. Along with demographic and lifestyle details, subjects were interviewed about their history of occurrence of malaria at all in previous 10 years. Their hematological, biochemical, and metabolic profile was assessed clinically as well as by investigations. The analysis was carried out with two groups: (1) those who were subjected with malaria at least once in past 10 years (); (2) those who never encountered malaria (Malaria Never Group).
RESULTS
Out of 126, 65 subjects were in and 61were in . There was no difference in lifestyle measures, hematological, and biochemical parameters. Mean G6PD levels were found similar in both the groups. Of 61 subjects in "malaria-never" group, 1 had deficient (1.1 unit/gm of Hb), 9 had low normal (between 2.5 and 10 units/gm of Hb), 48 had normal (10.1-20.5 units/gm of Hb), and 3 had higher than normal (>20.5 units/gm of Hb) G6PD levels. In comparison, 65 participants from "malaria ever" group, none was deficient, 6 had low normal, 58 had normal, and none had higher than normal G6PD levels. HPLC-based hemoglobin analysis showed significant higher number of participants in "malaria-never" group having altered hemoglobin. 12 participants had increased hemoglobin A2 levels, of which 10 were in "Malaria Occurrence Never" group; of them 6 could be diagnosed having hemoglobinopathy of specified variety. 3 of these 10 participants of "malaria-never" group had low G6PD levels also.
CONCLUSION
Malaria Protection Hypothesis was not found to be true as per our findings, but there were subtle hints that G6PD protection with or without change in hemoglobin alteration maybe operable.
背景
关于葡萄糖-6-磷酸脱氢酶（G6PD）与疟疾发生之间的证据尚不明确。开展了一项病例对照研究，以评估G6PD及其他生活方式因素与疟疾之间的保护关系。
方法
从一家三级医疗临床机构中随机选取126名医学专业人员。除了人口统计学和生活方式细节外，还询问了受试者过去10年中疟疾发生的病史。通过临床检查及实验室检测评估他们的血液学、生化和代谢指标。分析分为两组：（1）过去10年中至少患过一次疟疾的人（疟疾曾患组）；（2）从未患过疟疾的人（疟疾未患组）。
结果
126名受试者中，65人在疟疾曾患组，61人在疟疾未患组。生活方式指标、血液学和生化参数方面没有差异。两组的平均G6PD水平相似。在“疟疾未患”组的61名受试者中，1人G6PD缺乏（1.1单位/克血红蛋白），9人G6PD低正常（2.5至10单位/克血红蛋白之间），48人G6PD正常（10.1 - 20.5单位/克血红蛋白），3人G6PD高于正常（>20.5单位/克血红蛋白）。相比之下，“疟疾曾患”组的65名参与者中，无人G6PD缺乏，6人G6PD低正常，58人G6PD正常，无人G6PD高于正常。基于高效液相色谱法的血红蛋白分析显示，“疟疾未患”组中血红蛋白改变的参与者数量显著更多。12名参与者血红蛋白A2水平升高，其中10人在“从未患疟疾”组；其中6人可被诊断为特定类型的血红蛋白病。“疟疾未患”组的这10名参与者中有3人G6PD水平也较低。
结论
根据我们的研究结果，未发现疟疾保护假说成立，但有微妙迹象表明，无论血红蛋白改变与否，G6PD的保护作用可能是有效的。
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