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目的探讨糖尿病前期维生素D受体(VDR)基因Bsm I和Fok I位点多态性对HOMA指数的影响。方法在宁夏地区2008—2012年开展的横断面研究的基础上,根据美国糖尿病学会(ADA)的糖尿病诊断标准将339例正常组和468例糖尿病前期组进行比较研究,收集人体测量数据,采集空腹肘静脉血进行血液生化检测和胰岛素检测,并提取全血DNA进行基因分型。结果糖尿病前期组的BMI、腰围、空腹血糖(FPG)、胰岛素抵抗指数(HOMA-IR)均高于正常组(P<0.05),而B细胞功能指数(HOMA-B)和胰岛素敏感度(HOMA-S)值低于正常组(P<0.05);Bsm I位点中,糖尿病前期组携带基因型BB/Bb个体的HOMA-B低于bb携带者(P<0.05),而HOMA-S值明显高于bb携带者(P<0.05);在控制变量后,低HOMA-B值对Bsm I位点中携带基因型BB/Bb和Fok I位点FF/Ff/ff基因型个体均为糖尿病前期的危险因素(OR>1,P<0.05),无基因型特异性,但基因型ff个体的危险度最高(OR=10.59),低HOMA-S值和低HOMA-IR值在携带基因型Ff的个体中,均为糖尿病前期的危险因素(OR>1,P<0.05)。结论在糖尿病前期,VDR基因多态性与HOMA指数存在一定关联,Bsm I位点多态性可影响HOMA-B,而Fok I位点多态性可不同程度影响HOMA-B、HOMA-S和HOMA-IR。
Objective To investigate the influence of Bsm I and Fok I polymorphisms of pre-diabetes vitamin D receptor (VDR) gene on HOMA index. Methods Based on the cross-sectional study conducted in Ningxia from 2008 to 2012, 339 normal subjects and 468 pre-diabetic patients were compared according to the Diabetes Diagnostic Criteria of American Diabetes Association (ADA) to collect anthropometric data and collect fasting Elbow vein blood biochemical tests and insulin testing, and whole blood DNA extracted for genotyping. Results The BMI, waist circumference, fasting blood glucose (FPG) and insulin resistance index (HOMA-IR) in the pre-diabetes group were significantly higher than those in the normal group (P <0.05), while the B cell function index (HOMA-B) and insulin sensitivity (P <0.05). In the Bsm I locus, the HOMA-B of individuals with genotype BB / Bb in the pre-diabetes group was lower than those in the bb carriers (P <0.05), while the values of HOMA-S (P <0.05). After the control variables, the low HOMA-B values of all the individuals with genotype BB / Bb and FF / Ff / ff genotypes in Bsm I site were all diabetic There was no genotype-specific risk factor for early stage (OR> 1, P <0.05), but genotype ff was the highest (OR = 10.59), and low HOMA-S and low HOMA- Ff individuals were risk factors for pre-diabetes (OR> 1, P <0.05). Conclusions There is a correlation between VDR gene polymorphism and HOMA index in pre-diabetes. Bsm I polymorphism may affect HOMA-B. Fok I polymorphism may affect HOMA-B, HOMA-S and HOMA-IR.