摘要
目的探讨血管紧张素原(AGT)及血管紧张素Ⅱ1型受体(AT1R)基因多态性与2型糖尿病患者慢性肾脏病(CKD)的关系。方法将76例患CKD的2型糖尿病患者,根据肾穿刺活检病理分为糖尿病肾病(DN)组(28例)、非糖尿病性肾病(NDRD)组(30例)和DN合并NDRD组(18例);另外选择30名健康体检者作为正常对照组。采用聚合酶链反应-限制性片段长度多态性技术方法检测上述研究对象的AGT基因M235 T多态性和AT1R基因A1166C多态性。结果NDRD组的主要病理类型是为膜性肾病和IgA肾病,DN+NDRD组NDRD的主要病理类型为膜性肾病、IgA肾病和高血压性肾小动脉硬化,两组NDRD的病理类型均无显著性差异(P>0.05)。DN组和DN+NDRD组AGT基因M235 T-TT基因型频率明显高于NDRD组和正常对照组(P<0.05),T等位基因频率明显高于NDRD组(P<0.05)和正常对照组(P<0.01),NDRD组和正常对照组比较以及DN组和DN+NDRD组比较AGT-TT基因型和T等位基因频率均无明显差异(P>0.05)。各组AT1R基因A1166C多态性无显著性差异。AGT基因M235 T-TT基因型为2型糖尿病肾脏疾病患者eGFR下降的危险因素。结论AGT基因M235 T-TT基因型以及T等位基因与2型糖尿病患者DN及DN合并NDRD的发生有关,与NDRD的发生无关。AGT基因M235 T-TT基因型是2型糖尿病CKD患者肾功能减退的易感因素。AT1R基因多态性与2型糖尿病患者肾脏疾病的发生发展无关。
Objective To investigate the relationships of gene polymorphisms of angiotensinogen（AGT）and angiotensin Ⅱ type 1 receptor（AT1 R）with chronic kidney disease in type 2 diabetic patients.Methods The allele frequency and the genotype distribution of AGT M235 Tand AT1 R A1166 Cgene polymorphism were studied in 28 type 2 diabetic patients with diabetic nephropathy（DN）,30 type 2 diabetic patients with non-diabetic renal disease（NDRD）,18 type 2 diabetic patients with both DND and NDRD（DN＋NDRD）and 30 healthy controls by polymerase chain reaction（PCR）.Results Membranous nephropathy（MN）and IgA nephropathy were the main pathological profiles of the NDRD group,and MN,IgA nephropathy and benign arteriolar nephrosclerosis（BNS）were the main pathological profiles of the DN＋NDRD group.No significant differences were found in pathological profiles between the two groups.The frequency of AGT-TT genotype was significantly higher in DN and DN＋NDRD groups than in NDRD and healthy control groups（P〈0.05）.The frequency of AGT T allele was significantly higher in DN and DN＋NDRD groups than in NDRD（P〈0.05）and healthy control（P〈0.01）groups.No significant differences were found in AGT-TT genotype or AGT T allele between DN and DN＋NDRD groups,or between NDRD and healthy control groups.No significant differences were found in AT1 R A1166 C polymorphism among all groups.AGT M235 T-TT genotype was the risk of low estimated glomerular filtration rate（eGFR）.Conclusions AGT-TT genotype and AGT T allele may be association with the increased risk of DN and DN＋NDRD in type 2 diabetic patients.There may be no association between AGT-TT genotype or AGT T allele and the initiation of NDRD in type 2 diabetic patients.There may be no association between AT1 RA1166 Cpolymorphism with chronic kidney disease in type 2 diabetic patients.
作者
高妍婷
梁衍
孙燕
李振江
GAO Yan-ting, LIANG Yan, SUN Yan, LI Zhen-jiang.(Department of Nephrology , Shaanxi Provincial People＇s Hospital, Xi＇an 710068, Chin)
出处
《临床肾脏病杂志》
2018年第3期145-149,共5页
Journal Of Clinical Nephrology
基金
陕西省科技厅社发攻关项目(No.2014K11-03-04-05)
