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2型糖尿病患者基因多态性与肾损伤的相关性

Correlation between polymorphisms of gene and renal injury in patients with type 2 diabetes mellitus.

作者信息

Wu Su, Yi Bin, Dai Yali, Liao Xiangyu, Peng Juan, Li Aimei

机构信息

Department of Nephrology, Third Xiangya Hospital, Central South University, Changsha 410013.

Department of Nephrology, Fourth Hospital of Changsha, Changsha 410017, China.

出版信息

Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2024 Jul 28;49(7):1005-1014. doi: 10.11817/j.issn.1672-7347.2024.240186.

Abstract

OBJECTIVES

Genetic factors play an important role in the pathogenesis of diabetic kidney disease (DKD). Studies have shown that gene polymorphism is associated with the pathogenesis of type 2 diabetes mellitus (T2DM), but its role in DKD remains unclear. This study aims to analyze the distribution of alleles and genotypes of gene in patients with T2DM, and investigate the association between genetic polymorphism and DKD susceptibility in T2DM patients, which may provide new ideas for the pathogenesis of DKD.

METHODS

A toal of 205 T2DM patients who receiving treatment in the Third Xiangya Hospital of Central South University were divided into a DKD group (=100) and a DM group (=105) according to the presence of kidney injury, and 100 healthy volunteers were selected as NC group. Clinical data of the subjects were collected and estimated glomerular filtration rate (eGFR) were calculated. Genomic DNA was extracted and the genotypes of single nucleotide polymorphism (SNP) loci (rs11879029, rs11879010, and rs2241703) were determined using Sanger chain termination method. The genotype/allele frequencies among the 3 groups were compared. Logistic regression was used to analyze the correlation between SNP locus genotype of gene and risk of DKD in T2DM patients. According to the genotypes of rs11879029/rs11879010, T2DM patients were divided into a GG1/GG2 group, a GA1/GA2 group, and an AA1/AA2 group, and the clinical data were compared. Linkage disequilibrium analysis and haplotype analysis were performed.

RESULTS

The genotype distribution and allele frequencies of the rs11879029 and rs11879010 loci in the DKD group were significantly different in comparison with the NC and DM groups (all <0.05). For rs2241703, there were no differences in genotype and allele frequencies (all >0.05). After correcting by age, gender, systolic blood pressure, duration of diabetes, glycosylated hemoglobin, and serum albumin, rs11879029 and rs11879010 genotype were associated with DKD susceptibility in T2DM patients. Carriers of rs11879029 genotype AA were 6.27 times more likely to have DKD than carriers of genotype GG. And carriers of rs11879010 genotype AA were 4.72 times more likely to have DKD than carriers of genotype GG. The eGFR levels in the AA1/AA2 groups were significantly lower than those in the GG1/GG2 groups (both <0.05). Analysis of linkage disequilibrium showed complete linkage disequilibrium existed between rs11879029 and rs11879010, and the 2 SNPs (rs11879029 and rs11879010) were in strong linkage disequilibrium with rs2241703. Monotype GGG reduced the risk of DKD in T2DM patients (=0.53, 95% 0.35 to 0.81, =0.003), while haplotype AAG increased the risk of DKD in patients (=1.80, 95% 1.16 to 2.80, =0.008).

CONCLUSIONS

The genetic polymorphisms rs11879029 and rs11879010 of gene are potential contributors to the susceptibility of DKD in patients with T2DM, and allele A significantly increases the risk of DKD compared with allele G. The AA genotype might be a genetic risk factor for DKD.

摘要

目的

遗传因素在糖尿病肾病(DKD)的发病机制中起重要作用。研究表明,基因多态性与2型糖尿病(T2DM)的发病机制有关,但其在DKD中的作用仍不清楚。本研究旨在分析T2DM患者中该基因的等位基因和基因型分布,探讨该基因多态性与T2DM患者DKD易感性之间的关系,为DKD的发病机制提供新思路。

方法

选取在中南大学湘雅三医院接受治疗的205例T2DM患者,根据是否存在肾损伤分为DKD组(n = 100)和DM组(n = 105),并选取100例健康志愿者作为NC组。收集受试者的临床资料并计算估计肾小球滤过率(eGFR)。提取基因组DNA,采用桑格链终止法测定单核苷酸多态性(SNP)位点(rs11879029、rs11879010和rs2241703)的基因型。比较3组间的基因型/等位基因频率。采用逻辑回归分析该基因SNP位点基因型与T2DM患者DKD风险的相关性。根据rs11879029/rs11879010的基因型,将T2DM患者分为GG1/GG2组、GA1/GA2组和AA1/AA2组,并比较临床资料。进行连锁不平衡分析和单倍型分析。

结果

与NC组和DM组相比,DKD组rs11879029和rs11879010位点的基因型分布和等位基因频率有显著差异(均P<0.05)。对于rs2241703,基因型和等位基因频率无差异(均P>0.05)。经年龄、性别、收缩压、糖尿病病程、糖化血红蛋白和血清白蛋白校正后,rs11879029和rs11879010基因型与T2DM患者的DKD易感性相关。rs11879029基因型AA的携带者患DKD的可能性是基因型GG携带者的6.27倍。rs11879010基因型AA的携带者患DKD的可能性是基因型GG携带者的4.72倍。AA1/AA2组的eGFR水平显著低于GG1/GG2组(均P<0.05)。连锁不平衡分析显示rs11879029和rs11879010之间存在完全连锁不平衡,且这两个SNP(rs11879029和rs11879010)与rs2241703处于强连锁不平衡状态。单倍型GGG降低了T2DM患者患DKD的风险(OR = 0.53,95%CI 0.35至0.81,P = 0.003),而单倍型AAG增加了患者患DKD的风险(OR = 1.80,95%CI 1.16至2.80,P = 0.008)。

结论

该基因的遗传多态性rs11879029和rs11879010是T2DM患者DKD易感性的潜在因素等位基因A与等位基因G相比显著增加了DKD风险。AA基因型可能是DKD的遗传危险因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3cbe/11495987/4904a54130a3/ZhongNanDaXueXueBaoYiXueBan-49-7-1005-g001.jpg

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