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[目的]研究痛风伴胰岛素抵抗相关基因载脂蛋白AI-CⅢ-AIV(ApoAI-CⅢ-AIV)多态性,探讨该基因簇多态性对痛风伴胰岛素抵抗患者高脂血症的影响。[方法]痛风及痛风伴胰岛素抵抗病例均来自2008年2～12月在山东省随机选取的5个医院内科确诊的患者(分别为55、52例),同时,选取同期在该医院内科体检的健康志愿者作为对照(48人)。3组年龄、性别等经统计学分析无明显差异。应用多聚酶链反应、限制性片段长度多态性技术(PCR-RFLP)及生化分析方法,探讨ApoAI-CⅢ-AIV基因簇不同基因型与基因频率的分布,以及基因突变与血脂之间的相关,分析痛风伴胰岛素抵抗患者高脂血症与ApoAI-CⅢ-AIV基因簇之间的关系。[结果]痛风伴胰岛素抵抗患者血清总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、血尿酸(SUA)、血糖(FBG)及血浆胰岛素(FNS)水平高于痛风患者及健康志愿者(P<0.05或<0.01)。痛风伴胰岛素抵抗患者ApoAI-CⅢ-AIV基因簇-75位点A、+83位点T等位基因的频率及Xmn I位点突变型等位基因X2的频率较健康志愿者明显增高(P<0.05)。ApoAI-CⅢ-AIV基因簇MspI 1位点具有A/A基因型者血清TG、高密度脂蛋白胆固醇(HDL-C)及载脂蛋白AI(ApoAI)水平较具有G/G基因型者显著升高,ApoAI-CⅢ-AIV基因簇XmnI位点具有X2X2基因型者血清TG水平较具有X1X1基因型者为高(P<0.05)。痛风伴胰岛素抵抗患者TG水平升高是MspI 1位点A等位基因及XmnI位点X2等位基因两个多态位点联合作用的结果。[结论]痛风伴胰岛素抵抗患者ApoAI-CⅢ-AIV基因簇基因型和等位基因变化导致脂蛋白水平等相应改变,且与两个多态位点的协同效应有关。该基因簇与痛风伴胰岛素抵抗密切相关,提示痛风患者应积极预防控制代谢综合征相关疾病的发生发展和相互作用。
[Objective] To investigate the polymorphism of apolipoprotein AI-CⅢ-AIV (ApoAI-CⅢ-AIV) associated with gout and insulin resistance and to explore the influence of this gene cluster on hyperlipidemia in patients with gout and insulin resistance. [Methods] The cases of gout and gout with insulin resistance were all from 5 hospital-diagnosed patients (55 and 52 cases) randomly selected in Shandong Province from February to December in 2008. At the same time, Healthy volunteers served as controls (48). Three groups of age, gender and other statistical analysis showed no significant difference. To investigate the distribution of different genotypes and gene frequencies of ApoAI-CⅢ-AIV gene cluster by polymerase chain reaction, restriction fragment length polymorphism (PCR-RFLP) and biochemical analysis methods, and the correlation between gene mutation and blood lipid, To analyze the relationship between hyperlipidemia and ApoAI-CⅢ-AIV gene cluster in patients with gout and insulin resistance. [Results] The levels of total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C), blood uric acid (SUA), blood glucose (FBG) and plasma insulin (FNS) in patients with gout and insulin resistance Higher than gout patients and healthy volunteers (P <0.05 or <0.01). Compared with healthy volunteers, the frequency of T alleles at A + 83 locus and the Xmn I locus mutant allele X2 in ApoAI-CⅢ-AIV gene cluster of patients with gout and insulin resistance were significantly higher than those of healthy volunteers (P < 0.05). The level of serum TG, HDL-C and ApoAI in the ApoAI-CⅢ-AIV cluster with A / A genotype was significantly higher than those with G / G genotype The serum TG level of X2X2 genotype at XmnI locus of ApoAI-CⅢ-AIV gene cluster was higher than that of X1X1 genotype (P <0.05). Gout in patients with gout and insulin resistance elevated TG levels is MspI 1 A allele and XmnI locus X2 allele two polymorphic sites combined results. [Conclusion] The genotypes and alleles of ApoAI-CⅢ-AIV cluster in patients with gout and insulin resistance lead to the corresponding changes of lipoprotein levels, which are related to the synergistic effects of the two polymorphic loci. The gene cluster and gout with insulin resistance are closely related, suggesting that patients with gout should actively prevent and control the development and interaction of metabolic syndrome-related diseases.