2型糖尿病周围神经病变与载脂蛋白E基因多态性的相关性研究

摘要

Objective To investigate the relationship between apolipoprotein E (ApoE) gene polymorphism and type 2 diabetic peripheral neuropathy (DPN).Methods A total of 355 patients with type 2 diabetes mellitus (T2DM) were enrolled in this study and divided into 2 groups:patients with DPN (DPN group,n=215) and long duration (＞10 years) patients without DPN (T2DM group,n=140).And non-diabetic controls were selected as control group (NC,n=159).All the subjects were examined for the ankle reflex,vibration threshold value,10 g nylon silk,senses of temperature and pain and nerve conduction velocity.ApoE genotype was determined by PCR-RFLP and hybridization method by specific nucleic acid probe.Results (1) The frequencies of ApoE E4/X genotype,including E3/4 and E4/4 were higher in DPN group (28.9％) than in T2DM group (15.2％) and NC group (18.9％).The difference was statistically significant(P=0.003,0.026).E4 allele frequency was higher in DPN group (15.7％) than in T2DM group (8.9％) and NC group (9.7％).The difference was statistically significant(P=0.010,0.019).(2) Logistic regression analysis showed that ApoE gene polymorphism was associated with DPN and HbA1 c was a risk factor for DPN (P＜ 0.05).Conclusion Apolipoprotein E (ApoE) gene polymorphism may be associated with DPN.%目的 探讨载脂蛋白E(ApoE)基因多态性与DPN的相关性.方法 选取355例T2DM患者,其中伴DPN 215例(DPN组),T2DM病程＞10年无DPN者140例(T2DM组),糖代谢正常者159名作为对照(NC组).受试者均进行踝反射、振动觉、10 g尼龙丝、针刺痛觉、温度觉等体格检查及神经电生理检测.采用PCR扩增技术、特异性核酸探针杂交方法检测ApoE基因型.结果 (1)DPN组F4/X基因型(包括基因型E3/4和E4/4)频率(28.9％)高于T2DM组(15.2％)及NC组(18.9％) (P=0.003,0.026).E4等位基因频率(15.7％)高于T2DM组(8.9％)及NC组(9.7％)(P=0.010,0.019);(2) Logistic 回归分析显示,ApoE基因多态性与HbA1 c是DPN发生的危险因素(P＜0.05).结论 ApoE基因多态性可能与DPN有关.